Left Ventricular Function in Nigerians With Type 2 Diabetes Mellitus With and Without Hypertension

Abstract

Background. Diabetes mellitus is an established risk factor for  cardiovascular events and has been found to be independently associated with abnormal left ventricular function. We therefore decided to embark on this study to assess the left ventricular function in our diabetic patients.
Method. The study design was cross-sectional and conducted among patients attending out patient clinic of the Obafemi Awolowo University
Teaching Hospitals complex (OAUTHC) Ile Ife, Osun State south western Nigeria. It comprised 75 consecutive patients with type 2 diabetes mellitus
with or without hypertension and 50 apparently healthy age- and sex- comparable controls. Using a structured pre-evaluated questionnaire, the
demographic and clinical data were obtained. All subjects had two-dimensional (2D) M-mode, and Doppler echocardiography using Sonoline G60s Ultrasound imaging system with 4.2 MHZ transducer equipped with simultaneous ECG tracing.
Results. A total of 125 consecutive subjects were recruited comprising 75 patients with type 2 diabetes mellitus with or without hypertension and
50 apparently healthy age-and-sex comparable controls. There were no significant difference in left ventricular ejection fraction and fractional
shortening between the patients and controls. The ratio of early trans-mitral flow to late atrial filling of the left ventricle (E/A ratio), isovolumic left
ventricular relaxation time, and left ventricular deceleration time were predominantly prolonged among the study patients compared to the controls.
Conclusion. This study showed that left ventricular systolic function was preserved among patients with type 2 diabetes mellitus. The abnormal diastolic function noted was predominantly that of impaired relaxation
compared with controls. This is particularly more in hypertensive-diabetics than normotensive-diabetics.

Keywords: Diabetes mellitus, Left ventricular function.