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document
The development and feasibility of a composite score of echocardiographic indices that may stratify outcome in patients with diabetes mellitus . 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 .
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Intervention_Physical
Standard echocardiography
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Intervention_Physical
echocardiography
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Outcome_Physical
echo score
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Outcome_Physical
LV mass
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Outcome_Physical
LA volume , E : e '
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Outcome_Other
s
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Outcome_Other
objective summary score
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Outcome_Physical
heart failure ( HF )
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Outcome_Other
any CV event
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Outcome_Physical
development of HF
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Outcome_Other
score
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Participant_Condition
patients with diabetes mellitus
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Participant_Condition
type 2 diabetes ( T2DM )
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Participant_Sample-size
849
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Participant_Age
median age 65years
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Participant_Sex
female
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Participant_Condition
diabetes
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Participant_Condition
T2DM