The effects of good glycaemic control on left ventricular and coronary endothelial functions in patients with poorly controlled Type 2 diabetes mellitus. (18th July 2014)

• Record Type: Journal Article
• Authors: Erdogan, Dogan; Akcay, Salaheddin; Yucel, Habil; Ersoy, I. Hakkı; Icli, Atilla; Kutlucan, Ali; Arslan, Akif; Yener, Mahmut; Ozaydin, Mehmet; Tamer, M. Numan
• Is Part Of: Clinical endocrinology. Volume 82:Number 3(2015:Mar.)
• Page Start: 388
• Page End: 396
• Publication Date: 2014-07-18
• Subjects: Endocrinology -- Periodicals; 616.4005
• DOI: 10.1111/cen.12520
• Languages: English
• ISSNs: 0300-0664

Abstract

<abstract abstract-type="main" id="cen12520-abs-0001"> <title>Summary</title> <sec id="cen12520-sec-0001" sec-type="section"> <title>Objective</title> <p>Diabetics are at risk for developing overt heart failure and subclinical left ventricular (LV) dysfunction. Also, impaired coronary flow reserve (CFR) reflecting coronary microvascular dysfunction is common in diabetics. However, no substantial data regarding the effects of good glycaemic control on subclinical LV dysfunction and CFR are available.</p> </sec> <sec id="cen12520-sec-0002" sec-type="section"> <title>Context</title> <p>To investigate whether good glycaemic control had favourable effects on subclinical LV dysfunction and CFR.</p> </sec> <sec id="cen12520-sec-0003" sec-type="section"> <title>Design</title> <p>Prospective, open‐label, follow‐up study.</p> </sec> <sec id="cen12520-sec-0004" sec-type="section"> <title>Patients</title> <p>Diabetics (<italic>n</italic> = 202) were classified based on baseline HbA1C levels: patients with good (group 1) (<7·0%) and poor glycaemic control (≥7·0%).</p> </sec> <sec id="cen12520-sec-0005" sec-type="section"> <title>Measurements</title> <p>All patients underwent echocardiographic examination at baseline evaluation, and it was repeated at months 6 and 12. Based on HbA1C levels obtained at month 6, the patients with poor glycaemic control were divided into two groups: achieved (group 2) and not achieved good glycaemic control (group 3).</p> </sec> <sec id="cen12520-sec-0006" sec-type="section"> <title>Results</title> <p>The groups were comparable with respect to diastolic function parameters including left atrium diameter, mitral <italic>E</italic>/<italic>A</italic>, <italic> S</italic><sub>m</sub>, <italic>E</italic><sub>m</sub>/<italic>A</italic><sub>m</sub>, <italic>E</italic>/<italic>E</italic>′ and Tei index, and these parameters did not significantly change at follow‐up in the groups. At baseline, CFR was slightly higher in group 1 than in group 2 and group 3, but it did not reach statistically significant level. At follow‐up, CFR remained unchanged in group 1 (<italic>P</italic> = 0·58) and group 3 (<italic>P</italic> = 0·86), but increased in group 2 (<italic>P</italic> = 0·02: month 6 <italic>vs</italic> baseline and <italic>P</italic> = 0·004: month 12 <italic>vs</italic> baseline).</p> </sec> <sec id="cen12520-sec-0007" sec-type="section"> <title>Conclusions</title> <p>Diabetics with poor and good glycaemic control were comparable with respect to echocardiographic parameters reflecting subclinical LV dysfunction, and good glycaemic control did not affect these parameters. However, good glycaemic control improved CFR.</p> </sec> </abstract>