Non-invasive Markers and Left Ventricular Diastolic Dysfunction in Type II Diabetic Patients

Hussin Sherif, Abdelsalam El-sayed; Al-Daydammony, Mohammad Mustafa; Abdelmoneam Tantawy, Abdelmoneam Elkilany; Abdelbasit, Mohamed Salah

doi:10.21608/zumj.2025.364886.3859

Non-invasive Markers and Left Ventricular Diastolic Dysfunction in Type II Diabetic Patients

Document Type : Original Article

Authors

¹ Professor of Cardiology Department, Faculty of Medicine, Zagazig university, Egypt

² Department of Cardiology, Al-ahrar teaching hospital, Egypt

³ Lecturer of Cardiology Department, Faculty of Medicine, Zagazig university, Egypt

10.21608/zumj.2025.364886.3859

Abstract

Background: Type 2 diabetes mellitus (T2DM) is strongly associated with subclinical cardiovascular disease (CVD), often progressing undetected until advanced stages. Left ventricular diastolic dysfunction (LVDD) is a common but underrecognized complication, necessitating the identification of reliable, non-invasive predictive markers. This study aimed to evaluate non-invasive biomarkers for the early detection of LVDD in T2DM patients.

Methods: This case-control study included 60 patients with T2DM, stratified into two groups: Group A (n=30) with LVDD grade >1 and Group B (n=30) with mild or no LVDD. Comprehensive clinical assessments were performed, including vital signs, body mass index (BMI), and cardiovascular symptoms. Electrocardiographic (ECG) parameters, such as rhythm analysis, P-wave dispersion, and QT dispersion, were evaluated. Echocardiographic and tissue-Doppler imaging were conducted to assess diastolic function, alongside laboratory investigations including serum creatinine, serum uric acid, high-sensitivity C reactive protein (Hs-CRP), and neutrophil-lymphocyte ratio (NLR).

Results: Patients with LVDD (Group A) exhibited significantly elevated levels of serum creatinine, Hs-CRP, serum uric acid, and NLR. Urinary albumin excretion ranged from 45 to 290 mg/day (mean 168.4±7.6mg/day), and the albumin-to-creatinine ratio ranged from 3 to 16mg/mmol (mean 9.1±3.6 mg/mmol). In contrast, Group B demonstrated urinary albumin levels <30 mg/day and an albumin-to-creatinine ratio <1 mg/mmol.

Conclusion: Hs-CRP could be an independent predictor of LVDD emphasizing its potential use as a non-invasive biomarker for early screening and risk stratification in T2DM patients. Implementing Hs-CRP testing in routine clinical practice could facilitate early intervention strategies to prevent the progression of diastolic dysfunction and improve cardiovascular outcomes.

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