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- July 20, 2008 |
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"Which Cardiovascular Disease Should We Screen for in Diabetes?"Prof. Tom Marwick (biography)
English - 2007-03-03 - 37 minutes
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Summary :
Diabetic patients are at increased risk for heart failure, as seen in the Framingham Heart Study (1), and conversely there is an over-representation of diabetes in heart failure patients (2). The emphasis is now moving to treating the earlier stages A and B of heart failure, says Prof. Marwick. These are cases where risk factors for heart failure present, or risk factors plus some abnormal structure/function.
Diabetic heart disease has been defined as "myocardial disease in diabetic subjects that cannot be ascribed to hypertension, coronary artery disease or any other cardiac disease." The aspects of diabetic heart disease that have been recognised are its presentations (diastolic and systolic), its prevalence in diabetic patients, its independence from co-morbidity, and evidence in related metabolic disorders. Prof. Marwick shows several imaging techniques by which to visualise abnormalities of diabetic heart disease, evidence for a high prevalence of subclinical diabetic heart disease in asymptomatic, normotensive type 2 diabetic patients (3), and evidence for cardiac abnormalities in individuals with impaired glucose tolerance and obesity.
Is diabetic heart disease important at the preclinical stage? Prof. Marwick discusses its contribution to the reduced exercise capacity often seen in type 2 diabetic patients, and several potential mechanisms of diabetic heart disease.
Copyright © 2007 E-MedHosting.com Inc.
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- Heart failure in diabetes: epidemiology, prognosis
- Features of preclinical diabetic heart disease
- The impact of preclinical diabetic heart disease on exercise capacity in T2DM
- Five potential mechanisms of diabetic heart disease
Bibliographic references :
1. Kannel WB, Hjortland M, Castelli WP. "Role of diabetes in congestive heart failure: the Framingham study." Am J Cardiol. 1974 Jul;34(1):29-34.
2. Coughlin SS, Pearle DL, Baughman KL, Wasserman A, Tefft MC.Diabetes mellitus and risk of idiopathic dilated cardiomyopathy. The Washington, DC Dilated Cardiomyopathy Study. Ann Epidemiol. 1994 Jan;4(1):67-74.
3. John K. Boyer MD, Srihari Thanigaraj MD, Kenneth B. Schechtman PhD and Julio E. Pérez MD.Prevalence of ventricular diastolic dysfunction in asymptomatic, normotensive patients with diabetes mellitus The American Journal of Cardiology Volume 93, Issue 7, 1 April 2004, Pages 870-875.
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