TY - JOUR AU - Hillis Graham AU - Hirakawa Y. AU - Doughty R. AU - Woodward Mark AU - Triggs C. AU - Poppe K. AU - Whalley G. AU - Chalmers J. AU - Chow Clara AU - Patel Anushka AB -

BACKGROUND: Early detection of changes in cardiac structure and function associated with type 2 diabetes (T2DM) is important. However when multiple abnormalities are present, combining individual measurements can be subjective. This study sought to create a simple echo score that summarises measurements that may detect early and prognostically important changes in cardiac function. METHODS: Standard echocardiography was performed on 849 people with T2DM (median age 65years, 40% female, median duration of diabetes 5.5years). Principal components analysis was performed on measurements of LV mass, LA volume, E:e', and s', to create an objective summary score. The score was included in two Cox proportional hazard models adjusted for CV risk factors: one estimated the development of heart failure (HF) and the second estimated any CV event. RESULTS: The first two principal components represented 75% of the variation between the four echo measurements. A continuous score that represents the residual difference between these two components was derived that only requires measurement of medial E:e' and s'. The score was significantly associated with the development of HF within four years (hazard ratio 1.34; 95% CI 1.15, 1.56). CONCLUSIONS: We have developed a simple, objective score that enhances the use of echocardiography in the detection of sub-clinical cardiac disease in people with T2DM. Initial findings suggest that it may help identify those at increased risk of developing HF within four years.

AD - Department of Medicine and National Institute for Health Innovation, University of Auckland, Private Bag 92019, Auckland New Zealand; Department of Statistics, University of Auckland, Private Bag 92019, Auckland, New Zealand. Electronic address: k.poppe@auckland.ac.nz.
Faculty of Social and Health Sciences, Unitec Institute of Technology, Private Bag 92025, Auckland, New Zealand.
Department of Medicine and National Institute for Health Innovation, University of Auckland, Private Bag 92019, Auckland New Zealand.
The George Institute for Global Health, Level 13, 321 Kent Street, Sydney NSW 2000, Australia.
The George Institute for Global Health, Level 13, 321 Kent Street, Sydney NSW 2000, Australia; Westmead Hospital, University of Sydney, NSW 2006, Australia.
Department of Statistics, University of Auckland, Private Bag 92019, Auckland, New Zealand. AN - 25577772 BT - International Journal of Cardiology DP - NLM ET - 2015/01/13 LA - Eng LB - UK
PDO
CDV N1 - Poppe, Katrina K
Whalley, Gillian A
Doughty, Robert N
Woodward, Mark
Patel, Anushka
Chow, Clara K
Hirakawa, Yoichiro
Chalmers, John
Hillis, Graham S
Triggs, Christopher M
Int J Cardiol. 2014 Dec 27;182C:244-249. doi: 10.1016/j.ijcard.2014.12.087. N2 -

BACKGROUND: Early detection of changes in cardiac structure and function associated with type 2 diabetes (T2DM) is important. However when multiple abnormalities are present, combining individual measurements can be subjective. This study sought to create a simple echo score that summarises measurements that may detect early and prognostically important changes in cardiac function. METHODS: Standard echocardiography was performed on 849 people with T2DM (median age 65years, 40% female, median duration of diabetes 5.5years). Principal components analysis was performed on measurements of LV mass, LA volume, E:e', and s', to create an objective summary score. The score was included in two Cox proportional hazard models adjusted for CV risk factors: one estimated the development of heart failure (HF) and the second estimated any CV event. RESULTS: The first two principal components represented 75% of the variation between the four echo measurements. A continuous score that represents the residual difference between these two components was derived that only requires measurement of medial E:e' and s'. The score was significantly associated with the development of HF within four years (hazard ratio 1.34; 95% CI 1.15, 1.56). CONCLUSIONS: We have developed a simple, objective score that enhances the use of echocardiography in the detection of sub-clinical cardiac disease in people with T2DM. Initial findings suggest that it may help identify those at increased risk of developing HF within four years.

PY - 2014 SN - 1874-1754 (Electronic)
0167-5273 (Linking) SP - 244 EP - 249 T2 - International Journal of Cardiology TI - The development and feasibility of a composite score of echocardiographic indices that may stratify outcome in patients with diabetes mellitus VL - 182C ER -