Background Early detection of changes in cardiac structure and function associated with type 2 diabetes (T2DM) is important. However when multiple abnormalities are present, combining individual measurements can be subjective. This study sought to create a simple echo score that summarises measurements that may detect early and prognostically important changes in cardiac function. Methods Standard echocardiography was performed on 849 people with T2DM (median age 65 years, 40% female, median duration of diabetes 5.5 years). Principal components analysis was performed on measurements of LV mass, LA volume, E:e′, and s′, to create an objective summary score. The score was included in two Cox proportional hazard models adjusted for CV risk factors: one estimated the development of heart failure (HF) and the second estimated any CV event. Results The first two principal components represented 75% of the variation between the four echo measurements. A continuous score that represents the residual difference between these two components was derived that only requires measurement of medial E:e′ and s′. The score was significantly associated with the development of HF within four years (hazard ratio 1.34; 95% CI 1.15, 1.56). Conclusions We have developed a simple, objective score that enhances the use of echocardiography in the detection of sub-clinical cardiac disease in people with T2DM. Initial findings suggest that it may help identify those at increased risk of developing HF within four years.
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