Diastolic Heart Failure in Type Ii Diabetes Mellitus: Association with Clinic-Laboratory Parameters with Special Reference to Nt-Pro Bnp.

Abstract

A wealth of epidemiological evidence demonstrates that diabetes mellitus is independently associated with the risk of developing heart failure, with the risk increasing by more than twofold in men and by more than fivefold in women. Heart failure is highly prevalent (25 % in chronic heart failure and up to 40 % in acute heart failure) in patients with diabetes mellitus.

Objective: To determine the prevalence of diastolic heart failure in patients with type 2 Diabetes mellitus and its association with different parameters and NTPROBNP.

Methodology: This study was hospital based Cross-sectional observational study conducted in In-patient and outpatient department of Apollo Gleneagles Hospitals Kolkata involving 85 patients between 40-65 years of age both males and females from the general medical inpatient and outpatient pool of Apollo Gleneagles Hospitals Kolkata.

Results: Prevalence of diastolic dysfunction was 63.5% among the patients with type-2 DM. Only 14.8% and 7.4% of the patients had Grade-III and Grade-IV DM respectively. All the parameters of the patients with DM higher than that of the patients without DM and there were mostly significantly higher (p<0.01). Proportion of patients with all clinical parameters was significantly higher among the patients with DM than that of without DM (p<0.01). One way ANOVA showed that there was significant difference in level of NTPRO of the patients with different grades. As per CD the mean NTPRO increased significantly with the increase in grade of DM (p<0.01).

Conclusion: Prevalence of DM in the group of patients with duration of diabetes of ≥10 years is more as compared to the patients with duration of diabetes of <10 yrs. The prevalence of diastolic dysfunction increased with longer duration of diabetes.  NT-ProBNP level helps in diagnosing HFPEF cases with equivocal echo findings of diastolic dysfunction. NT-ProBNP level was significantly higher in patients with diastolic heart failure than the value required for diagnosis of HFPEF in the present study.