A Cross Sectional study on Diastolic Function and Factors Influencing Diastolic Function in Diabetes Mellitus Patients with Normal Systolic Function

Venkateswari, S (2016) A Cross Sectional study on Diastolic Function and Factors Influencing Diastolic Function in Diabetes Mellitus Patients with Normal Systolic Function. Masters thesis, Chengalpattu Medical College, Chengalpattu.

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Abstract

INTRODUCTION: The disease burden of diabetes mellitus is increasing worldwide at a tremendous rate. Many studies have reported the occurrence of heart failure in diabetic patients is high even in the absence of coronary artery disease and hypertension. There is high prevalence of pre-clinical diastolic dysfunction as per the studies. Evidence suggests that diastolic dysfunction precedes systolic dysfunction in diabetic patients. So far only few population based studies have been conducted in India to demonstrate diastolic dysfunction in diabetic patients. AIMS &OBJECTIVES: 1. To determine the prevalance of LV diastolic dysfunction in asymptomatic type 2 DM patient. 2. To quantify the relation of LV diastolic dysfunction with Age, Sex, Duration of DM, Control of Diabetes, Smoking, Lipid profile, Obesity indices. Study Group: Subjects with Diabetes mellitus for more than five years attending medicine and diabetology out patient departments. Study Setting: Hospital based. Study Period: One year. Study Design: Cross sectional study. Study Population: Rural and suburban population in and around Chengalpattu. Study Place: Department of General Medicine, Chengalpattu Medical College, Chengalpattu. Ethical Clearance: Ethical committee clearance obtained. Financial Support: Self. Inclusion Criteria: 1. All Type 2 Diabetes Mellitus patients of age 40 to 80 years. 2. Duration more than five years. 3. Normal left ventricular systolic function. Exclusion Criteria: 1. Subjects with history of angina, chest pain, Electrocardiogram (ECG) changes and abnormal Treadmill test (TMT) results. 2. Subjects with evidence of valvular disease. 3. Hypertensive. 4. Subjects with poor transthoracic ECHO window. MATERIALS AND METHODS: From all patients included in the study a detailed medical history is to be obtained using the questionnaire. The patients were then subjected to physical examination which includes general examination, system wise examination and anthropometric evaluation including weight in kilogram, height in meter. Electrocardiogram was done in all subjects. Biochemical investigations includes collection of venous blood sample after a 12 hour fast and sending it to the biochemical laboratory for estimation of plasma glucose level, total serum cholesterol (TC), High –density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol, very low density lipoprotein cholesterol (VLDL) and serum triglyceride levels (TG). STATISTICAL ANALYSIS: Descriptive statistics to be done for all data and suitable statistical tests of comparison to be done. Continuous variables to be analysed with the unpaired t-test and categorical variables to be analysed with the Chi-Square Test with Yates correction. Statistical significance is taken as P < 0.05. RESULTS: In the present study, seven parameters namely age, sex, glycaemic control, duration of diabetes, obesity, dyslipidemia and smoking studied for correlation.among these five parameters namely age, glycaemic control, duration of diabetes, obesity and dyslipidemia were found to have positive correlation with prevalence of diastolic dysfunction in diabetic patients that is the prevalence of diastolic dysfunction increased with increase in age, poor glycaemic control, increasing duration of diabetes, presence of dyslipidemia and obesity. Gender and smoking habit were not found to have significant correlation with prevalence of diastolic dysfunction in diabetic patients in the present study. CONCLUSION: The prevalence of diastolic dysfunction in asymptomatic type 2 DM patients is high and found to be 72 % in the present study. The occurrence of diastolic dysfunction seems to preceed the occurrence of systolic dysfunction in diabetes patients.There is a significant correlation between duration of diabetes, glycaemic control, age, obesity, dyslipidemia and diastolic dysfunction among the seven parameters considered in the present study. Persons with type 2 diabetes mellitus should be screened with echocardiography for subclinical diastolic dysfunction. Early diagnosis and initiation of appropriate treatment for diastolic dysfunction would slow down the progression to diastolic heart failure and cause significant reduction in the morbidity and mortality in patients with diabetes.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Diabetes mellitus ; diastolic function ; Echocardiography.
Subjects: MEDICAL > General Medicine
Depositing User: Subramani R
Date Deposited: 06 Feb 2019 02:21
Last Modified: 06 Feb 2019 02:21
URI: http://repository-tnmgrmu.ac.in/id/eprint/10498

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