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Shin-Young Choi, Ka Young Moon, Yoo-Ri Chung, Kihwang Lee; Diabetes and Diabetic Retinopathy are associated with Impaired Myocardial Function in Patients with Cardiomyopathy. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2889.
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© ARVO (1962-2015); The Authors (2016-present)
Diabetes is associated with microvascular complications including diabetic retinopathy (DR), while risk for macrovascular complications such as coronary artery disease or stroke is also higher in patients with type 2 diabetes. Diabetic cardiomyopathy, a rare condition of myocardial dysfunction without coronary artery disease, seems to have microvascular component. We performed a retrospective clinical study to investigate the association of DR with diabetic cardiomyopathy.
Data were collected retrospectively from 139 patients with cardiomyopathy (58 with type 2 diabetes and 81 without diabetes) and no evidence of coronary artery disease. Echocardiographic parameters, laboratory data including lipid profiles and fundus findings were obtained from medical records. Left ventricular ejection fraction (LVEF) less than 40% was defined as impaired myocardial function.
Type of cardiomyopathy was significantly different according to the presence of diabetes, with higher prevalence of dilated type in diabetic patients (79% vs 53%, P = 0.001). LVEF was significantly decreased in diabetic patients than those without diabetes (43% vs 53%, P = 0.003), while patients with DR showed less LVEF than those without DR among diabetic patients (37% vs 49%, P = 0.016). Among parameters involving diastolic function, patients with DR showed higher E/E’ ratio (left ventricular filling pressures) than those without DR (23.0 vs 12.8, P = 0.011). Logistic regression analysis showed that diabetes significantly increased the risk of impaired LVEF (odd ratio (OR): 3.11, 95% confidence interval (CI): 1.51-6.42, P = 0.002), while the presence of DR showed similar tendency in diabetic patients (OR: 4.06, 95% CI: 1.33-12.34, P = 0.014).
Diabetes increased the risk of systolic dysfunction in patients with cardiomyopathy, while DR was associated with both systolic and diastolic dysfunction. Diabetic retinopathy may represent widespread systemic microcirculation disease, and lead to increased load to the heart and compromise cardiac performance.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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