To evaluate left bundle-branch block as an indicator of advanced cardiovascular involvement in diabetic patients by examining left ventricular systolic function and proteinurea.
Data of 26 diabetic patients with left bundle-branch block (Group 1) were compared with that of 31 diabetic patients without left bundle-branch block (Group 2) and 18 non-diabetic patients with left bundle-branch block (Group 3). The inclusion criteria were age >45 years and diabetes mellitus type-2 of >5 years. Age, sex, race, ethanol use, hypertension, thyroid disease, and coronary artery disease were matched among groups.
Mean age of patients in Group 1, Group 2, and Group 3 was 67±8, 68±10, and 65±10 years, respectively (p=NS). Black and Hispanic patients were 90%, 90%, and 88% (p=NS) and females were 64%, 62%, and 63% (p=NS) in Group 1, Group 2, and Group 3, respectively. Left ventricular ejection fraction in Group 1 was significantly lower than that in Group 2 and Group 3 (30±10% vs. 49±12% and 47±8%, respectively, p<0.01). Left ventricular end diastolic volume was significantly higher in Group 1 than that in Group 2 (188.6 ml vs. 147.5 ml, p<0.03). Similarly, left ventricular end systolic volume was significantly higher in Group 1 than that in Group 2 (135.4 ml vs. 83.7 ml, p<0.02). No significant difference was seen in left atrial size (4.0 cm Group 1 vs. 4.3 cm Group 2, p=NS). Proteinurea in Group 1 (79.4 mg/dL) was significantly higher than that in Group 2 (35.6 mg/dL, p<0.05) and Group 3 (7.1 mg/dL, p<0.05). However, there was no significant difference in HbA1C levels in Group 1 and Group 2 patients (9.01% vs. 7.81%, p=NS).CONCLUSIONS: Left bundle-branch block in diabetic patients indicates advanced cardiovascular involvement manifesting with more severe left ventricular systolic dysfunction and proteinurea.
Diabetic patients with left bundle-branch block should be evaluated for left ventricular systolic dysfunction and proteinurea by transthoracic echo and urine analysis.
N. Singh, None.