@article{3119628,
    title = "Early left ventricular systolic dysfunction in asymptomatic patients with type 1 diabetes: a single-center, pilot study",
    author = "Kapelios, C.J. and Bonou, M. and Barmpagianni, A. and Tentolouris, A. and Tsilingiris, D. and Eleftheriadou, I. and Skouloudi, M. and Kanellopoulos, P.N. and Lambadiari, V. and Masoura, C. and Makrilakis, K. and Katsilambros, N. and Barbetseas, J. and Liatis, S.",
    journal = "Journal of Diabetes and its Complications",
    year = "2021",
    volume = "35",
    number = "6",
    publisher = "HANLEY & BELFUS-ELSEVIER INC",
    issn = "1056-8727",
    doi = "10.1016/j.jdiacomp.2021.107913",
    keywords = "amino terminal pro brain natriuretic peptide;  glucagon like peptide 1 derivative;  hemoglobin A1c;  insulin;  sodium glucose cotransporter 2 inhibitor;  troponin T;  glycosylated hemoglobin, adult;  arterial stiffness;  Article;  asymptomatic disease;  autonomic nervous system function;  body mass;  cardiovascular risk factor;  cross-sectional study;  data analysis software;  diabetic microangiopathy;  diabetic patient;  disease duration;  Doppler echocardiography;  female;  glomerulus filtration rate;  human;  insulin dependent diabetes mellitus;  insulin treatment;  left ventricular systolic dysfunction;  major clinical study;  male;  pilot study;  prevalence;  priority journal;  sex difference;  speckle tracking echocardiography;  two dimensional echocardiography;  complication;  heart left ventricle function;  insulin dependent diabetes mellitus;  middle aged;  risk factor;  young adult, Adult;  Cross-Sectional Studies;  Diabetes Mellitus, Type 1;  Female;  Glycated Hemoglobin A;  Humans;  Male;  Middle Aged;  Pilot Projects;  Risk Factors;  Ventricular Dysfunction, Left;  Ventricular Function, Left;  Young Adult",
    abstract = "Aims: Prevalence and risk factors of pre-symptomatic left ventricular systolic dysfunction (LVSD) in individuals with type 1 diabetes (T1D) have not been adequately studied. The present cross-sectional study assessed the prevalence of early LVSD in asymptomatic patients with type 1 diabetes and investigated potential risk factors. Methods: Consecutive patients with T1D, free of cardiovascular disease and significant evident microvascular complications were examined. LVSD was assessed by speckle-tracking echocardiography and calculation of global longitudinal strain (GLS). Abnormal GLS was defined as a value>-18.7%. We looked for possible associations between the presence of LVSD and patient demographic, clinical and laboratory characteristics, as well as with autonomic nervous system (ANS) function and arterial stiffness. Results: We enrolled 155 T1D patients (29.7% men, age 36.7 ± 13.1 years, diabetes duration 19.1 ± 10.0 years, HbA1c 7.5 ± 1.4% [58 ± 15 mmol/mol]). Early LVSD was prevalent in 53 (34.2%) patients. Multivariable analysis identified male gender (OR:4.14; 95% CI:1.39–12.31, p = 0.011), HbA1c (OR:1.59 per 1% increase; 95% CI:1.11–2.28, p = 0.011), glomerular filtration rate (GFR, OR:0.97; 95% CI:0.95–0.99, p = 0.010) and BMI (OR:1.19; 95% CI:1.06–1.34, p = 0.003) as independent predictors of LVSD presence. Conclusions: Early subclinical LVSD is a common finding in asymptomatic patients with T1D, free of macrovascular and significant microvascular complications. Apart from chronic hyperglycemia, increased adiposity may be implicated in its etiology. Further investigation is warranted to identify patients at high risk for whom early screening is required and to determine possible associations between risk markers identified in the present analysis and long-term outcomes. © 2021 Elsevier Inc."
}