ABSTRACT
Aims: Diastolic dysfunction is frequent in patients with type 2 diabetes mellitus (DM2) and associated with a poor prognosis. This study aimed to describe diastolic function changes over time in DM2 patients and to identify predictive factors of diastolic function deterioration. Methods and results: Diastolic function was assessed by echocardiography according to the EACVI/ASE recommendations at baseline and 3-year follow-up in a prospective cohort of 310 DM2 patients without overt heart disease. Predictors of diastolic function deterioration were identified using logistic regression analysis. During the 3-year follow-up, prevalence of diastolic dysfunction increased from 49% to 67% (P = 0.001). Only 32% of the patients had a normal diastolic function both at baseline and 3 years and 27% of the patients presented diastolic function deterioration. At multivariable analysis, age (OR = 1.05 [1.01-1.09], P < 0.01), retinopathy (OR = 2.00 [1.10-3.63], P = 0.02), and increase in systolic blood pressure during follow-up (OR = 1.03 [1.01-1.04], P < 0.01) were predictive of diastolic function deterioration. Conclusion: Age, retinopathy, and increase in blood pressure over time are associated with an increased risk of diastolic function deterioration in DM2 patients. The presence of these co-factors might help to early identify patients at risk of heart failure.
Subject(s)
Diabetes Mellitus, Type 2/epidemiology , Echocardiography/methods , Ventricular Dysfunction, Left/diagnostic imaging , Ventricular Dysfunction, Left/epidemiology , Adult , Aged , Cohort Studies , Comorbidity , Diabetes Mellitus, Type 2/diagnosis , Diabetes Mellitus, Type 2/drug therapy , Diastole , Disease Progression , Female , Follow-Up Studies , France , Hospitals, University , Humans , Logistic Models , Male , Middle Aged , Multivariate Analysis , Predictive Value of Tests , Prospective Studies , Severity of Illness Index , Time FactorsABSTRACT
Tyrosine-kinase inhibitors are recent therapy used in different neoplastic diseases. Dysthyroidism seems to be a class effect of these drugs with a potentially cross cumulative effect. We describe here the case of a man who first developed dysthyroidism with sunitinib, then a deep and permanent hypothyroidism when axitinib was introduced.
Subject(s)
Hypothyroidism/chemically induced , Imidazoles/adverse effects , Indazoles/adverse effects , Indoles/adverse effects , Protein Kinase Inhibitors/adverse effects , Protein Kinase Inhibitors/classification , Pyrroles/adverse effects , Vascular Endothelial Growth Factor A/antagonists & inhibitors , Adult , Axitinib , Drug Substitution , Humans , Hypothyroidism/diagnosis , Imidazoles/therapeutic use , Indazoles/therapeutic use , Indoles/therapeutic use , Kidney Neoplasms/drug therapy , Kidney Neoplasms/pathology , Male , Pyrroles/therapeutic use , SunitinibABSTRACT
Tyrosine-kinase inhibitors are recent therapy used in different neoplastic diseases. Dysthyroidism seems to be a class effect of these drugs with a potentially cross cumulative effect. We describe here the case of a man who first developed dysthyroidism with sunitinib, then a deep and permanent hypothyroidism when axitinib was introduced.
