Introduction
Methods
Patient cohort and investigations
Risk stratification and assessment of CAD
Echocardiography
LV function
LV structure
Statistical analysis
Results
Patient characteristics
All patients (n = 200) | Patients with NT-proBNP ≤ 45.2 ng/l (n = 96) | Patients with NT-proBNP > 45.2 ng/l (n = 104) | p-values | |
---|---|---|---|---|
Sex no. (male%) | 76 | 78 | 74 | 0.51 |
Age (years) | 59 ± 9 | 55.4 ± 10 | 61.7 ± 9 | 0.0001 |
Known duration of diabetes (years) | 13 ± 7 | 10.8 ± 7 | 14.6 ± 7 | 0. 0.001 |
BMI (kg/m2) | 32.6 ± 5.8 | 32.9 ± 5.6 | 32.3 ± 5.9 | 0.48 |
HbA1c (%) | 7.9 ± 1.3 | 8.00 ± 1.3 | 7.7 ± 1.4 | 0.18 |
Systolic blood pressure (mmHg) | 130 ± 17 | 131 ± 16 | 130 ± 18 | 0.55 |
Diastolic blood pressure (mmHg) | 75 ± 11 | 76 ± 10 | 74 ± 12 | 0.18 |
Total cholesterol (mmol/l) | 3.9 ± 0.9 | 4.1 ± 0.9 | 3.8 ± 1.0 | 0.032 |
Plasma creatinine (μmol/l) | 76 ± 18 | 71.9 ± 16 | 80.6 ± 19 | 0.001 |
Haemoglobin (mmol/l) | 8.6 ± 0.85 | 8.8 ± 0.9 | 8.4 ± 0.9 | 0.001 |
Heart rate variability during deep breathing (bpm) * | 7 (4.5-11.5) | 8 (42-205) | 6 (4-10) | 0.0001 |
Vibratory perception threshold mV - mean of both sides | 33 ± 15 | 28.5 ± 14 | 37.9 ± 14 | 0.0001 |
Retinopathy no. (%) | 120 (60) | 44 (45) | 76 (73) | 0.0001 |
Urinary albumin excretion rate (mg/24 h)* | 103 (39 - 230) | 103 (38 - 491) | 101 (38 - 286) | 0.70 |
Peripheral systolic blood pressure (mmHg - worst big toe) | 121 ± 34 | 125 ± 32 | 117 ± 35 | 0.35 |
Carotid intima-media thickness (mm) | 0.73 (0.15) | 0.71 ± 0.16 | 0.75 ± 0.14 | 0.15 |
Carotid compliance a (l/mmHg) | 0.0026 ± 0.001 | 0.0025 ± 0.001 | 0.0026 ± 0.001 | 0.30 |
Coronary Calcium Score* | 183 (0-4529) | 87 (1-426) | 251 (24-872) | 0.014 |
Oral antidiabetic medication no. (%) | 170 (85) | 85 (89) | 85 (82) | 0.18 |
Insulin treatment no. (%) | 124 (62) | 59(61) | 65 (63) | 0.88 |
RAAS blockade no. (%) | 196 (98) | 94 (98) | 102 (98) | 0.94 |
Statin therapy no. (%) | 189 (95) | 91 (95) | 98 (94) | 0.82 |
Aspirin therapy no. (%) | 183 (92) | 87 (91) | 96 (92) | 0.80 |
Beta-blocker therapy no. (%) | 27 (14) | 4 (4) | 23 (22) | 0.0001 |
Calcium channel blockers no. (%) | 80 (40) | 36 (36) | 44 (44) | 0.25 |
Diuretics no. (%) | 128 (64) | 56 (58) | 72 (69) | 0.11 |
Prevalences overall of echocardiography abnormalities
All patients (n = 200) | Patients with NT-proBNP ≤ 45.2 ng/l (n = 96) | Patients with NT-proBNP > 45.2 ng/l (n = 104) | p-values | |
---|---|---|---|---|
Left ventricular structure | ||||
Left ventricular end-diastolic volume [ml] | 127.0 ± 28.9 | 129 ± 28.5 | 130 ± 31.9 | 0.85 |
Left ventricular end-systolic volume [ml] | 52.0 ± 15.5 | 53.5 ± 16.7 | 53.9 ± 16.7 | 0.74 |
Left atrial volume index biplane [ml/m2] | 25.6 ± 6.4 | 24.5 ± 6.1 | 26.7 ± .6.7 | 0.021 |
LV mass, g, | 188.8 ± 52.6 | 203.1 ± 48.0 | 180.9 ± 53.5 | 0.11 |
LV mass/height2,7, [g/m2.7] | 41.2 ± 10.9 | 39.85 ± 10.8 | 42.43 ± 10.7 | 0.10 |
Left ventricular systolic function | ||||
Left ventricular ejection fraction [%] | 59.5 ± 4.8 | 58.6 ± 5.7 | 59.9 ± 4.3 | 0.50 |
Peak mitral annular systolic velocity (s') [cm/s] | 8.49 ± 1.58 | 8.71 ± 1.60 | 8.28 ± 1.54 | 0.057 |
Left ventricular diastolic function and grade | ||||
Isovolumetric relaxation time [ms] | 86.1 ± 15.8 | 88.3 ± 17.6 | 84.8 ± 14.7 | 0.14 |
Mitral valve E-wave deceleration time [ms] | 201.0 ± 39.5 | 203.8 ± 38.0 | 199.6 ± 40.4 | 0.48 |
Mitral valve E-wave deceleration slope [m/s2] | 3.7 ± 1.1 | 3.7 ± 1.1 | 3.8 ± 1.1 | 0.088 |
Peak mitral valve E-velocity [m/s] | 0.71 ± 0.15 | 0.71 ± 0.15 | 0.71 ± 0.15 | 0.95 |
Peak mitral valve A-velocity [m/s] | 0.93 ± 0.22 | 0.82 ± 0.17 | 0.77 ± 0.17 | 0.033 |
E/A ratio | 0.93 ± 0.20 | 0.94 ± 20 | 0.92 ± 0.23 | 0.60 |
Peak early mitral annular diastolic velocity (e' lateral) [cm/s] | 8.86 ± 2.34 | 9.23 ± 2.55 | 8.50 ± 2.06 | 0.032 |
Peak atrial mitral annular diastolic velocity (a') [cm/s] | 9.82 ± 2.28 | 10.21 ± 2.18 | 9.62 ± 2.31 | 0.088 |
E/e' lateral ratio | 8.51 ± 2.63 | 9.10 ± 2.89 | 7.94 ± 2.71 | 0.025 |
Diastolic dysfunction grade I no. (%) | 7 (3.5) | 2 (2) | 6 (6) | 0.12 |
Diastolic dysfunction grade II no. (%) | 102 (51) | 47 (49) | 55 (53) | 0.31 |
Diastolic dysfunction grade III no. (%) | 0 | 0 | 0 | - |
Right ventricular structure and function | ||||
Right atrial volume single plane [ml/m2] | 23.7 ± 9.0 | 22.4 ± 8.7 | 25.2 ± 9.2 | 0.033 |
Mid-RV diameter [cm] | 3.9 ± 0.5 | 4.0 ± 0.5 | 3.9 ± 0.5 | 0.34 |
Tricuspid annular plane systolic excursion ^[cm] | 2.65 ± 0.45 | 2.62 ± 0.43 | 2.67 ± 0.45 | 0.47 |
Peak tricuspid regurgitation gradient ~ [mmHg] | 18.2 ± 7.2 | 17.4 ± 6.8 | 18.5 ± 7.3 | 0.44 |
LV structure and function
Left ventricular (LV) hypertrophy in women (n = 46)* | Normal no. (%) | Mild no. (%) | Moderate no. (%) | Severe no. (%) |
---|---|---|---|---|
LV mass, g, 67-162, 163-186, 187-210 and ≥ 211 | 24 (52) | 10 (22) | 7 (15) | 5 (11) |
LV mass/BSA, g/m2, 43-95, 96-108, 109-121 and ≥ 122 | 40 (87) | 3(7) | 1(2) | 2 (4) |
LV mass/height, g/m, 41-99, 100-115, 116-128 and ≥ 129 | 24 (52) | 14 (30) | 5 (11) | 3 (7) |
LV mass/height2,7, g/m2,7, 18-44, 45-51, 52-58 and ≥ 59 | 28 (61) | 14 (30) | 2 (4) | 2 (4) |
Relative wall thickness, cm, 0.22-0.42, 0.43-0.47, 0.48-0.52 and ≥ 0.53 | 19 (41) | 8 (17) | 9 (20) | 10 (22) |
LV hypertrophy in men (n = 149)* | Normal no. (%) | Mild no. (%) | Moderate no. (%) | Severe no. (%) |
LV mass, g, 88-224, 225-258, 259-292 and ≥ 293 | 111 (75) | 21 (14) | 8 (5) | 9 (6) |
LV mass/BSA, g/m2 49-115, 116-131, 132-148 and ≥ 149 | 135 (91) | 10 (7) | 2 (1) | 2 (1) |
LV mass/height, g/m, 52-126, 127-144, 145-162 and ≥ 163 | 116 (78) | 17 (11) | 11 (7) | 5 (3) |
LV mass/height2,7, g/m2,7, 20-48, 49-55, 56-63 and ≥ 64 | 119 (80) | 16 (11) | 10 (7) | 4 (3) |
Relative wall thickness, cm, 0.24-0.42, 0.43-0.46, 0.47-0.51 and ≥ 0.52 | 56 (38) | 27 (18) | 29 (19) | 37 (25) |