Factors associated with silent myocardial ischemia, autonomic or peripheral neuropathies, and survival in diabetes mellitus type 2 patients without cardiovascular symptoms
Author
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Massardo Vega, Teresa
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Araya, A. V.
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Prat Martorell, Hernán
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Alarcón, L.
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Berrocal, I.
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Pino, A.
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Cordero, F.
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Jaimovich, R.
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Fernández, R.
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Herrera, E.
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Carmona, J.
Author
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Castro, A.
Admission date
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2020-04-21T01:31:25Z
Available date
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2020-04-21T01:31:25Z
Publication date
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2020
Cita de ítem
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International Journal of Diabetes in Developing Countries (January–March 2020) 40(1):80–86
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Identifier
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10.1007/s13410-019-00758-7
Identifier
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https://repositorio.uchile.cl/handle/2250/173957
Abstract
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Introduction Complications from diabetes mellitus (DM) include cardiovascular system, peripheral neuropathy (PN), and autonomic dysfunction (AD). Goal: Assess the association of silent myocardial ischemia, AD, and PN in cardiovascular asymptomatic type 2 diabetics. Methods As part of a multicenter project, 40 patients with type 2 DM were studied, with > 5 years of known disease and a baseline electrocardiogram non suggestive of coronary artery disease. Myocardial SPECT was performed with exercise stress test measuring corrected QT interval (QTc) and heart rate recovery (HRR) post-exercise (abnormal QTc >= 450 ms at rest and HRR < 14 beats at the first minute in maximum exercise). After 3 years, it was possible to re-study 32 cases. PN was evaluated with Michigan Neuropathy Screening Instrument (MNSI). Logistic regression analysis was performed to determine associated factors for AD, PN, SI, and survival analysis. Results Thirty-four percent of the group had ischemia in SPECT; QTc was prolonged in 23.3%; 31% fulfilled criteria of PN; and 25% of AD due to HRR alteration. With bivariate and multivariate analyses, associations were observed between lipid, glycemic parameters, ischemia, PN, and AD. The follow-up (mean 119 months) consigned 4 cardiac-related deaths; ischemia, glycemic control parameters, and microalbuminuria had significant value in bivariate analysis. Conclusion In our small sample of asymptomatic cardiovascular type 2 DM patients, myocardial ischemia, glycemic control, and microalbuminuria have influence on survival, requiring a more intensive global therapeutic approach.
International Journal of Diabetes in Developing Countries
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Keywords
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Diabetes mellitus
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Keywords
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Autonomic dysfunction
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Keywords
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Peripheral neuropathy
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Keywords
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Silent myocardial ischemia
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Keywords
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SPECT
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Título
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Factors associated with silent myocardial ischemia, autonomic or peripheral neuropathies, and survival in diabetes mellitus type 2 patients without cardiovascular symptoms