The high prevalence of abnormal cardiac function in diabetic patients of a developing community
Hamid Bazrafshan1, Mohammad Ali Ramezani2,3, Ahmadali Shirafkan2,3, Hasan Ahangar1 & Ali Gholamrezanezhad1
Introduction: Cardiac complications are one of the most important long-term adverse effects of diabetes mellitus (DM), which is usually under diagnosed, as it is frequently asymptomatic. As it seems that the control of DM in developing nations is not optimal, it can be predicted that the prevalence of cardiac complications of DM is subsequently high. We assessed the prevalence of such complications in a developing community in the north of Iran.
Method: Two hundred consecutive patients (mean age: 50/9 years) who returned to the diabetic care clinic of the hospital for follow-up of their known DM were assessed. For all patients, levels of HbA1C and B-mode echocardiography were done. Their echocardiography systolic and diastolic dysfunction were assessed and E (early diastolic filling phase) and A (A trial contraction phase) were recorded. Ejection fraction (EF) was calculated using Simpsons method.
Results: Overall 29.5% of the diabetic patients showed abnormal systolic function. The study showed statistically significant association between the level of HbA1C and EF (P<0.001). Also there was a significant association between the level of HbA1C and diastolic function (P<0.001). Three percent of patients had mild diastolic dysfunction (E=A), while 45.5% showed moderate to severe dysfunction. The mean reduction in EF was statistically correlated with the duration of DM. Regression analysis showed that the associations were not affected by the patients age (P<0.001).
Conclusion: The frequency of abnormal cardiac function is significantly high in patients with DM. Poor control of DM is a major contributing factor. Screening of patients using echocardiography (especially when DM control is not favorable) is advised.