PMID- 33478961
OWN - NLM
STAT- MEDLINE
DCOM- 20210419
LR  - 20210419
IS  - 2044-6055 (Electronic)
IS  - 2044-6055 (Linking)
VI  - 11
IP  - 1
DP  - 2021 Jan 21
TI  - Observational study investigating the prevalence of asymptomatic stage B heart 
      failure in patients with type 2 diabetes who are not known to have coronary 
      artery disease.
PG  - e039869
LID - 10.1136/bmjopen-2020-039869 [doi]
LID - e039869
AB  - OBJECTIVE: To identify the prevalence of stage B heart failure (SBHF) in patients 
      with type 2 diabetes mellitus (T2DM) with no history of cardiovascular disease 
      (CVD). DESIGN: Observational study. SETTING: A single-centre study in which 
      eligible patients were recruited from T2DM clinic. Following consent, patients 
      completed a questionnaire and underwent physical examinations. Patients had blood 
      drawn for laboratory investigations and had a transthoracic echocardiography. 
      PARTICIPANTS: A total of 305 patients who were not known to have CVD were 
      recruited. Patients with deranged liver function tests and end stage renal 
      failure were excluded. MAIN OUTCOME MEASURES: Echocardiographic parameters such 
      as left ventricular ejection fraction, left ventricular mass index (LVMI), left 
      ventricular hypertrophy, left atrial enlargement and diastolic function were 
      examined. RESULTS: A total of 305 patients predominantly females (65%), with mean 
      body mass index of 27.5 kg/m(2) participated in this study. None of them had 
      either a history or signs and symptoms of CVD. Seventy-seven percent of patients 
      had a history of hypertension and 83% of this study population had T2DM for more 
      than 10 years. Mean HbA1c of 8.3% was recorded. Almost all patients were taking 
      metformin. Approximately, 40% of patients were on newer anti-T2DM agents such as 
      sodium-glucose cotransporter-2 and dipeptidyl peptidase 4 inhibitors. Fifty-seven 
      percent (n=174) of the study population had SBHF at the time of study: diastolic 
      dysfunction, increased LVMI and increased left atrial volume index (LAVI) were 
      noted in 51 patients (17%), 128 patients (42%) and 98 patients (32%), 
      respectively. Thirty-seven patients (12%) had both increase LVMI and LAVI. 
      CONCLUSION: Our study has revealed a high prevalence of SBHF in T2DM patients 
      without overt cardiac disease in Malaysia that has one of the highest prevalence 
      of TDM in the world.
CI  - (c) Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Oo, Mon Myat
AU  - Oo MM
AUID- ORCID: 0000-0003-3534-7605
AD  - Division of Cardiology, Department of Medicine, University Malaya Medical Centre, 
      Kuala Lumpur, Selangor, Malaysia monmyat85@gmail.com.
FAU - Tan Chung Zhen, Isaiah
AU  - Tan Chung Zhen I
AD  - Department of Medicine, Hospital Queen Elizabeth, Kota Kinabalu, Sabah, Malaysia.
FAU - Ng, Kee Seong
AU  - Ng KS
AD  - Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Wilayah 
      Persekutuan, Malaysia.
FAU - Tan, Kok Leng
AU  - Tan KL
AD  - Division of Cardiology, Department of Medicine, University Malaya Medical Centre, 
      Kuala Lumpur, Selangor, Malaysia.
FAU - Tan, Alexander T B
AU  - Tan ATB
AD  - Division of Cardiology, Department of Medicine, University Malaya Medical Centre, 
      Kuala Lumpur, Selangor, Malaysia.
FAU - Vethakkan, Shireene Ratna
AU  - Vethakkan SR
AD  - Division of Endocrinology, Department of Medicine, University Malaya Medical 
      Centre, Kuala Lumpur, Malaysia.
FAU - A/L Ratnasingam, R Jeyakantha
AU  - A/L Ratnasingam RJ
AD  - Division of Cardiology, Department of Medicine, University Malaya Medical Centre, 
      Kuala Lumpur, Selangor, Malaysia.
FAU - Chee, Kok Han
AU  - Chee KH
AD  - Division of Cardiology, Department of Medicine, University Malaya Medical Centre, 
      Kuala Lumpur, Selangor, Malaysia.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20210121
PL  - England
TA  - BMJ Open
JT  - BMJ open
JID - 101552874
SB  - IM
MH  - Cardiomyopathies/epidemiology
MH  - Coronary Artery Disease/*epidemiology
MH  - Diabetes Mellitus, Type 2/complications/*epidemiology
MH  - Echocardiography
MH  - Female
MH  - Heart Failure/diagnostic imaging/*epidemiology
MH  - Humans
MH  - Hypertension/epidemiology
MH  - Malaysia/epidemiology
MH  - Male
MH  - Middle Aged
MH  - Prevalence
MH  - Risk Factors
MH  - Stroke Volume
MH  - Ventricular Dysfunction, Left/diagnostic imaging/epidemiology
MH  - Ventricular Function, Left
PMC - PMC7825254
OTO - NOTNLM
OT  - cardiomyopathy
OT  - echocardiography
OT  - general diabetes
OT  - heart failure
OT  - hypertension
COIS- Competing interests: None declared.
EDAT- 2021/01/23 06:00
MHDA- 2021/04/20 06:00
PMCR- 2021/01/21
CRDT- 2021/01/22 06:15
PHST- 2021/01/22 06:15 [entrez]
PHST- 2021/01/23 06:00 [pubmed]
PHST- 2021/04/20 06:00 [medline]
PHST- 2021/01/21 00:00 [pmc-release]
AID - bmjopen-2020-039869 [pii]
AID - 10.1136/bmjopen-2020-039869 [doi]
PST - epublish
SO  - BMJ Open. 2021 Jan 21;11(1):e039869. doi: 10.1136/bmjopen-2020-039869.