Prevalence and associations of asymptomatic left ventricular systolic dysfunction in Lebanese patients with type 2 diabetes mellitus

Abstract

Diabetes Mellitus is a prevalent disease with a growing impact on individuals worldwide. Evaluating the prevalence of subclinical left ventricular dysfunction and understanding its associations with microvascular complications, uncontrolled glycemia, diabetes duration, and patient age is crucial. Our aim is to determine the utility of screening for this condition. Methods We conducted a retrospective cohort study involving 159 asymptomatic individuals with type 2 diabetes. Bivariate analysis was employed to assess potential factors and their associations with subclinical left ventricular dysfunction. Patients with a history of cardiac disease or interventions were excluded. Results The average age of our sample was 61.5 years. Almost half of the patients exhibited an HbA1c exceeding 7% (50.3%), and approximately half had an ejection fraction (EF) of less than 55% (50.9%). In the bivariate analysis, a notable difference in microvascular diabetic complications was observed among different EF groups. Specifically, nephropathy (62%), neuropathy (57.5%), and retinopathy (74.4%) were significantly more prevalent among patients with an EF < 55%. We also identified a significant age difference between groups, with a higher mean diabetes duration (14.1 ± 7.7 years) in the lower EF group. Notably, 63.7% of patients with an HbA1c exceeding 7% exhibited an EF < 55%. Older patients were associated with a lower EF, with an adjusted odds ratio (aOR) of 0.94. An HbA1c of 7% or less was linked to a higher likelihood of an EF > 55%. Conclusion We established a correlation between subclinical left ventricular systolic dysfunction and microvascular complications. However, further extensive prospective research is necessary to deepen our understanding of these associations and their clinical implications.