Early detection and significance of structural cardiovascular abnormalities in patients with Type 2 diabetes mellitus

Abstract

Cardiovascular disease is the leading cause of death among patients with Type 2 diabetes mellitus. The main forms of structural heart disease associated with diabetes are coronary heart disease and diabetic cardiomyopathy, which is characterized by left ventricular hypertrophy, left ventricular diastolic and systolic dysfunction. Asymptomatic structural heart disease is common and associated with a poor prognosis in patients with diabetes. Contemporary practice guidelines do not recommend screening of asymptomatic individuals for structural heart disease. Potential screening modalities, such as echocardiography, are costly and inaccessible. A simple, inexpensive blood test for brain natriuretic peptide is a useful marker of structural heart disease and is a prime candidate for screening patients with Type 2 diabetes mellitus and prioritizing referral for echocardiography.

Keywords::

• coronary heart disease
• diabetes
• diabetic cardiomyopathy
• diastolic dysfunction
• left ventricular hypertrophy
• systolic dysfunction

Financial & competing interests disclosure

Dr Jithendra Somaratne is supported by the Douglas Goodfellow Medical Research Fellowship by the Auckland Medical Research Foundation and the Greenlane Research and Educational Fund. Dr Gillian Whalley is currently the National Heart Foundation of New Zealand Senior Fellow. Assoc Prof Robert Doughty and Dr Gillian Whalley have received an unrestricted research grant from Instit de Recherches Internationales Servier to support the ADVANCE Echocardiography Substudy. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.