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- Publisher Website: 10.1136/postgradmedj-2022-141548
- Scopus: eid_2-s2.0-85142932356
- PMID: 35260482
- WOS: WOS:000766725000001
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Article: Opportunistic screening for asymptomatic left ventricular dysfunction in type 2 diabetes mellitus
Title | Opportunistic screening for asymptomatic left ventricular dysfunction in type 2 diabetes mellitus |
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Authors | |
Keywords | general diabetes heart failure |
Issue Date | 2022 |
Citation | Postgraduate Medical Journal, 2022, article no. 141548 How to Cite? |
Abstract | Background: International guidelines recommend natriuretic peptide biomarker-based screening for patients at high heart failure (HF) risk to allow early detection. There have been few reports about the incorporation of screening procedure to existing clinical practice. Objective: To implement screening of left ventricular dysfunction in patients with type 2 diabetes mellitus (DM). Method: A prospective screening study at the DM complication screening centre was performed. Results: Between 2018 and 2019, 1043 patients (age: 63.7±12.4 years; male: 56.3%) with mean glycated haemoglobin of 7.25%±1.34% were recruited. 81.8% patients had concomitant hypertension, 31.1% had coronary artery disease, 8.0% had previous stroke, 5.5% had peripheral artery disease and 30.7% had chronic kidney disease (CKD) stages 3-5. 43 patients (4.1%) had an elevated N-Terminal prohormone of brain natriuretic peptide (NT-proBNP) concentration above the age-specific diagnostic thresholds for HF, and 43 patients (4.1%) had newly detected atrial fibrillation (AF). The prevalence of elevated NT-proBNP increased with age from 0.85% in patients aged <50 years to 7.14% in those aged 70-79 years and worsening kidney function from 0.43% in patients with CKD stage 1 to 42.86% in CKD stage 5. In multivariate logistic regression, male gender (OR: 3.67 (1.47-9.16), p=0.005∗), prior stroke (OR: 3.26 (1.38-7.69), p=0.007∗), CKD (p<0.001∗) and newly detected AF (OR: 7.02 (2.65-18.57), p<0.001∗) were significantly associated with elevated NT-proBNP. Among patients with elevated NT-proBNP, their mean left ventricular ejection fraction (LVEF) was 51.4%±14.7%, and 45% patients had an LVEF <50%. Conclusion: NT-proBNP and ECG screening could be implemented with relative ease to facilitate early detection of cardiovascular complication and improve long-Term outcomes. |
Persistent Identifier | http://hdl.handle.net/10722/311746 |
ISSN | 2023 Impact Factor: 3.6 2023 SCImago Journal Rankings: 0.876 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Zhou, M | - |
dc.contributor.author | Huang, D | - |
dc.contributor.author | Cheng, Y | - |
dc.contributor.author | Lau, YM | - |
dc.contributor.author | Lai, WH | - |
dc.contributor.author | Lau, YM | - |
dc.contributor.author | Hai, SHJJ | - |
dc.contributor.author | Lau, CP | - |
dc.contributor.author | Chan, EWY | - |
dc.contributor.author | Yue, WS | - |
dc.contributor.author | Zuo, ML | - |
dc.contributor.author | Yin, LX | - |
dc.contributor.author | Feng, Y | - |
dc.contributor.author | Tan, N | - |
dc.contributor.author | Chen, J | - |
dc.contributor.author | Li, XL | - |
dc.contributor.author | Tse, HF | - |
dc.contributor.author | Lee, CHP | - |
dc.contributor.author | Chow, WS | - |
dc.contributor.author | Siu, DCW | - |
dc.contributor.author | Wong, CK | - |
dc.date.accessioned | 2022-04-01T09:12:40Z | - |
dc.date.available | 2022-04-01T09:12:40Z | - |
dc.date.issued | 2022 | - |
dc.identifier.citation | Postgraduate Medical Journal, 2022, article no. 141548 | - |
dc.identifier.issn | 0032-5473 | - |
dc.identifier.uri | http://hdl.handle.net/10722/311746 | - |
dc.description.abstract | Background: International guidelines recommend natriuretic peptide biomarker-based screening for patients at high heart failure (HF) risk to allow early detection. There have been few reports about the incorporation of screening procedure to existing clinical practice. Objective: To implement screening of left ventricular dysfunction in patients with type 2 diabetes mellitus (DM). Method: A prospective screening study at the DM complication screening centre was performed. Results: Between 2018 and 2019, 1043 patients (age: 63.7±12.4 years; male: 56.3%) with mean glycated haemoglobin of 7.25%±1.34% were recruited. 81.8% patients had concomitant hypertension, 31.1% had coronary artery disease, 8.0% had previous stroke, 5.5% had peripheral artery disease and 30.7% had chronic kidney disease (CKD) stages 3-5. 43 patients (4.1%) had an elevated N-Terminal prohormone of brain natriuretic peptide (NT-proBNP) concentration above the age-specific diagnostic thresholds for HF, and 43 patients (4.1%) had newly detected atrial fibrillation (AF). The prevalence of elevated NT-proBNP increased with age from 0.85% in patients aged <50 years to 7.14% in those aged 70-79 years and worsening kidney function from 0.43% in patients with CKD stage 1 to 42.86% in CKD stage 5. In multivariate logistic regression, male gender (OR: 3.67 (1.47-9.16), p=0.005∗), prior stroke (OR: 3.26 (1.38-7.69), p=0.007∗), CKD (p<0.001∗) and newly detected AF (OR: 7.02 (2.65-18.57), p<0.001∗) were significantly associated with elevated NT-proBNP. Among patients with elevated NT-proBNP, their mean left ventricular ejection fraction (LVEF) was 51.4%±14.7%, and 45% patients had an LVEF <50%. Conclusion: NT-proBNP and ECG screening could be implemented with relative ease to facilitate early detection of cardiovascular complication and improve long-Term outcomes. | - |
dc.language | eng | - |
dc.relation.ispartof | Postgraduate Medical Journal | - |
dc.subject | general diabetes | - |
dc.subject | heart failure | - |
dc.title | Opportunistic screening for asymptomatic left ventricular dysfunction in type 2 diabetes mellitus | - |
dc.type | Article | - |
dc.identifier.email | Hai, SHJJ: haishjj@hku.hk | - |
dc.identifier.email | Lau, CP: cplau@hkucc.hku.hk | - |
dc.identifier.email | Chan, EWY: ewchan@hku.hk | - |
dc.identifier.email | Tse, HF: hftse@hkucc.hku.hk | - |
dc.identifier.email | Lee, CHP: pchlee@hku.hk | - |
dc.identifier.email | Chow, WS: chowws01@hkucc.hku.hk | - |
dc.identifier.email | Siu, DCW: cwdsiu@hkucc.hku.hk | - |
dc.identifier.authority | Hai, SHJJ=rp02047 | - |
dc.identifier.authority | Chan, EWY=rp01587 | - |
dc.identifier.authority | Tse, HF=rp00428 | - |
dc.identifier.authority | Lee, CHP=rp02043 | - |
dc.identifier.authority | Siu, DCW=rp00534 | - |
dc.identifier.doi | 10.1136/postgradmedj-2022-141548 | - |
dc.identifier.pmid | 35260482 | - |
dc.identifier.scopus | eid_2-s2.0-85142932356 | - |
dc.identifier.hkuros | 332411 | - |
dc.identifier.spage | article no. 141548 | - |
dc.identifier.epage | article no. 141548 | - |
dc.identifier.isi | WOS:000766725000001 | - |