02211nas a2200241 4500000000100000008004100001100001800042700001600060700001500076700001800091700001400109700001300123700001500136700001600151700001500167700001800182245014700200250001500347300001200362490000900374520153500383020005101918 2014 d1 aHillis Graham1 aHirakawa Y.1 aDoughty R.1 aWoodward Mark1 aTriggs C.1 aPoppe K.1 aWhalley G.1 aChalmers J.1 aChow Clara1 aPatel Anushka00aThe development and feasibility of a composite score of echocardiographic indices that may stratify outcome in patients with diabetes mellitus a2015/01/13 a244-2490 v182C3 a

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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