The E/e' ratio difference between subjects with type 2 diabetes and controls. A meta-analysis of clinical studies.
Giacomo ZoppiniCorinna BergaminiAlessandro MantovaniMarco DaurizGiovanni TargherAndrea RossiEnzo BonoraPublished in: PloS one (2018)
Type 2 diabetes is associated with an increased risk of heart failure. Left ventricular diastolic dysfunction and type 2 diabetes are frequently associated. Using echocardiography, we know that tissue Doppler imaging E/e' ratio is a reliable predictor of left ventricular filling pressure. We performed a systematic review and meta-analysis to investigate the averaged E/e' ratio value in patients with type 2 diabetes compared to non-diabetic controls. In the analysis we included cross-sectional studies providing the averaged E/e' ratio. Subgroup/sensitivity analyses were conducted according to variables known to influence E/e' ratio measurements. The analysis included 15 cross sectional studies with 877 type 2 diabetes patients and 1193 controls. The weighted mean difference showed higher values in diabetes (WMD 2.02; 95% CI 1.35, 2.70; p<0.001). The result was consistent in the subgroup/sensitivity analyses. Visual inspection of the funnel plot did not identify substantial asymmetry and the Egger test for funnel plot asymmetry showed a p value of 0.36. In conclusion, our assessment suggests that averaged E/e' ratio is consistently increased in patients with type 2 diabetes compared to non-diabetic controls in the absence of cardiovascular diseases and complicated hypertension. This alteration may be a precocious diastolic alteration in the diabetic cardiomyopathy.
Keyphrases
- left ventricular
- type diabetes
- heart failure
- cross sectional
- cardiovascular disease
- blood pressure
- ejection fraction
- glycemic control
- hypertrophic cardiomyopathy
- cardiac resynchronization therapy
- aortic stenosis
- acute myocardial infarction
- insulin resistance
- left atrial
- end stage renal disease
- high resolution
- randomized controlled trial
- oxidative stress
- chronic kidney disease
- pulmonary hypertension
- adipose tissue
- computed tomography
- clinical trial
- percutaneous coronary intervention
- prognostic factors
- blood flow
- peritoneal dialysis
- contrast enhanced
- phase iii
- patient reported
- data analysis