Open AccessThe E/e’ ratio difference between subjects with type 2 diabetes and controls. A meta-analysis of clinical studies
Author(s) -
Giacomo Zoppini,
Corinna Bergamini,
Alessandro Mantovani,
Marco Dauriz,
Giovanni Targher,
Andrea Rossi,
Enzo Bonora
Publication year - 2018
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0209794
Subject(s) - medicine , funnel plot , diabetes mellitus , cardiology , publication bias , type 2 diabetes , meta analysis , subgroup analysis , diabetic cardiomyopathy , type 1 diabetes , heart failure , cardiomyopathy , endocrinology
Type 2 diabetes is associated with an increased risk of heart failure. Left ventricular diastolic dysfunction and type 2 diabetes are frequently associated. Using echocardiography, we know that tissue Doppler imaging E/e’ ratio is a reliable predictor of left ventricular filling pressure. We performed a systematic review and meta-analysis to investigate the averaged E/e’ ratio value in patients with type 2 diabetes compared to non-diabetic controls. In the analysis we included cross-sectional studies providing the averaged E/e’ ratio. Subgroup/sensitivity analyses were conducted according to variables known to influence E/e’ ratio measurements. The analysis included 15 cross sectional studies with 877 type 2 diabetes patients and 1193 controls. The weighted mean difference showed higher values in diabetes (WMD 2.02; 95% CI 1.35, 2.70; p<0.001). The result was consistent in the subgroup/sensitivity analyses. Visual inspection of the funnel plot did not identify substantial asymmetry and the Egger test for funnel plot asymmetry showed a p value of 0.36. In conclusion, our assessment suggests that averaged E/e’ ratio is consistently increased in patients with type 2 diabetes compared to non-diabetic controls in the absence of cardiovascular diseases and complicated hypertension. This alteration may be a precocious diastolic alteration in the diabetic cardiomyopathy.