THE EFFECT OF DIABETES MELLITUS DURATION ON CARDIOVASCULAR REMODELING
Abstract
Objective: To evaluate the effect of disease duration on the development of cardiovascular remodeling in patients with type2 diabetes mellitus(T2DM) and atherosclerotic cardiovascular disease(ASCVD). Design and method: This study included 285 patients with T2DM and ASCVD. The mean age of the patients was 64.11 ± 1.2 years, with 34%males and 66%females. Myocardial structural and functional status and remodeling processes were assessed using Doppler echocardiography. The common carotid intima-media thickness(IMT) was measured using high-resolution ultrasonography. Patients with preserved or mildly reduced ejection fractions were included in this study. Statistical analysis was performed using IBMSPSS Statistics for Windows version27.0. Results: Patients were divided into two groups according to the duration of T2DM: group 1, patients with a diabetes duration of up to 5 years(n=236)and group 2 patients with a disease duration of > 5 years (n=49). The duration of diabetes was 1.36 ± 0.9 years vs 11.9 ± 4.6 years, respectively. Both groups were compared in terms of age, sex, ambulatory systolic blood pressure (SBP)and diastolic blood pressure(DBP). No significant differences in SBP or DBP were observed between the groups. Comparison of fasting glucose levels showed significantly higher values in group 2:5.8±1.9mmol/l vs 10.15±2.9mmol/l, p=0.0001.Comparison of central hemodynamic parameters revealed larger values in group 2:LVESD–3.42±0.49 cm vs3.8±0.65 cm, p=0.001;LVEDD–5.08±0.5 cm vs 5.33±0.5 cm, p=0.002;ESV-49.9±18,5 ml vs 65.18±28,6 ml, p=0.001;EDV–124.7±27.7 ml vs 138.8±29.8 ml, p=0.0002. IVST was significantly higher in group 2:1.16±0.13 cm vs 1.19 ± 0.1 cm, p=0.05; PWT–1.14 ± 0.14 cm vs 1.18±0.12 cm, p=0.03;LVEF showed a statistically significant difference between the two groups: 60.78±7.05% vs 54.59±10.6%, p=0.001.LVM 234.9±63.7 g vs 266.77±58.97gp=0.005 and LVM) 152.79±41.9 g/m2vs 173.4±43.5 g/m2, p=0.002 were significantly higher in group 2 patients compared to group 1.LVH was more prevalent in Group 2 (67% vs. 89%; p=0.05). Assessment of carotid vessels revealed:Right Carotid IMT– 1.0±0.18 mm vs 3.0±0.89 mm, p=0.002; Left Carotid IMT–1.02±0.19 mm vs 4.69±1.6 mm, p=0.002;Thickness of atherosclerotic plaque of right carotid artery was 15.75±18.1 mm vs 24.37±19.7 mm, p=0.003;Thickness of atherosclerotic plaque of right carotid artery was 30.7±18.7 mm vs 34.7±20.1 mm, p=0.05. Furthermore, a positive correlation was found between diabetes duration (r=0.2, p<0.001) and EDV (r=0.11, p=0.05), ESV (r=0.69, p=0.004), IVST(r=0.29, p=0.001), PWT (r=0.18, p=0.001), LVM (r=0.13, p=0.03) and LVMI (r=0.12, p=0.05). A negative correlation was found between diabetes duration and EF(r= -0.205, p=0.001). Conclusions: Duration diabetes mellitus significantly affects the development of cardiovascular remodeling.