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Article: Opportunistic screening for asymptomatic left ventricular dysfunction in type 2 diabetes mellitus

TitleOpportunistic screening for asymptomatic left ventricular dysfunction in type 2 diabetes mellitus
Authors
Keywordsgeneral diabetes
heart failure
Issue Date2022
Citation
Postgraduate Medical Journal, 2022, article no. 141548 How to Cite?
AbstractBackground: 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 Identifierhttp://hdl.handle.net/10722/311746
ISSN
2021 Impact Factor: 4.973
2020 SCImago Journal Rankings: 0.568
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorZhou, M-
dc.contributor.authorHuang, D-
dc.contributor.authorCheng, Y-
dc.contributor.authorLau, YM-
dc.contributor.authorLai, WH-
dc.contributor.authorLau, YM-
dc.contributor.authorHai, SHJJ-
dc.contributor.authorLau, CP-
dc.contributor.authorChan, EWY-
dc.contributor.authorYue, WS-
dc.contributor.authorZuo, ML-
dc.contributor.authorYin, LX-
dc.contributor.authorFeng, Y-
dc.contributor.authorTan, N-
dc.contributor.authorChen, J-
dc.contributor.authorLi, XL-
dc.contributor.authorTse, HF-
dc.contributor.authorLee, CHP-
dc.contributor.authorChow, WS-
dc.contributor.authorSiu, DCW-
dc.contributor.authorWong, CK-
dc.date.accessioned2022-04-01T09:12:40Z-
dc.date.available2022-04-01T09:12:40Z-
dc.date.issued2022-
dc.identifier.citationPostgraduate Medical Journal, 2022, article no. 141548-
dc.identifier.issn0032-5473-
dc.identifier.urihttp://hdl.handle.net/10722/311746-
dc.description.abstractBackground: 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.languageeng-
dc.relation.ispartofPostgraduate Medical Journal-
dc.subjectgeneral diabetes-
dc.subjectheart failure-
dc.titleOpportunistic screening for asymptomatic left ventricular dysfunction in type 2 diabetes mellitus-
dc.typeArticle-
dc.identifier.emailHai, SHJJ: haishjj@hku.hk-
dc.identifier.emailLau, CP: cplau@hkucc.hku.hk-
dc.identifier.emailChan, EWY: ewchan@hku.hk-
dc.identifier.emailTse, HF: hftse@hkucc.hku.hk-
dc.identifier.emailLee, CHP: pchlee@hku.hk-
dc.identifier.emailChow, WS: chowws01@hkucc.hku.hk-
dc.identifier.emailSiu, DCW: cwdsiu@hkucc.hku.hk-
dc.identifier.authorityHai, SHJJ=rp02047-
dc.identifier.authorityChan, EWY=rp01587-
dc.identifier.authorityTse, HF=rp00428-
dc.identifier.authorityLee, CHP=rp02043-
dc.identifier.authoritySiu, DCW=rp00534-
dc.identifier.doi10.1136/postgradmedj-2022-141548-
dc.identifier.pmid35260482-
dc.identifier.scopuseid_2-s2.0-85142932356-
dc.identifier.hkuros332411-
dc.identifier.spagearticle no. 141548-
dc.identifier.epagearticle no. 141548-
dc.identifier.isiWOS:000766725000001-

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