Skip to main content
Journal cover image

Strategy to identify subjects with diabetes mellitus more suitable for selective echocardiographic screening: The DAVID-Berg study.

Publication ,  Journal Article
Gori, M; Canova, P; Calabrese, A; Cioffi, G; Trevisan, R; De Maria, R; Grosu, A; Iacovoni, A; Fontana, A; Ferrari, P; Greene, SJ; Parati, G ...
Published in: Int J Cardiol
December 1, 2017

BACKGROUND: Despite the burden of pre-clinical heart failure (HF) among diabetes mellitus (DM) patients, routine screening echocardiography is not currently recommended. We prospectively assessed risk prediction for HF/death of a screening strategy combining clinical data, electrocardiogram, NTproBNP, and echocardiogram, aiming to identify DM patients more suitable for selective echocardiography. METHODS: Among 4047 screened subjects aged≥55/≤80years, the DAVID-Berg Study prospectively enrolled 623 outpatients with DM, or hypertension, or known cardiovascular disease but with no HF history/symptoms. The present analysis focuses on data obtained during a longitudinal follow-up of the 219 patients with DM. RESULTS: Mean age was 68years, 61% were men, and median DM duration was 4.9years. During a median follow-up of 5.2years, 50 subjects developed HF or died. A predictive model using clinical data demonstrated moderate predictive power, which significantly improved by adding electrocardiogram (C-statistic 0.75 versus 0.70; p<0.05), but not NTproBNP (C-statistic 0.72, p=0.20). Subjects with normal clinical variables or abnormal clinical variables but normal electrocardiogram had low events rate (1.3 versus 2.4events/100-person-years, p=NS). Conversely, subjects with both clinical and electrocardiogram abnormalities (47%) carried higher risk (9.0events/100-person-years, p<0.001). The predictive power for mortality/HF development increased when echocardiography was added (13.6events/100-person-years, C-statistic 0.80, p<0.05). CONCLUSIONS: Our prospective study found that a selective echocardiographic screening strategy guided by abnormal clinical/electrocardiogram data can reliably identify DM subjects at higher risk for incident HF and death. This screening approach may hold promise in guiding HF prevention efforts among DM patients.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Int J Cardiol

DOI

EISSN

1874-1754

Publication Date

December 1, 2017

Volume

248

Start / End Page

414 / 420

Location

Netherlands

Related Subject Headings

  • Risk Factors
  • Prospective Studies
  • Middle Aged
  • Male
  • Humans
  • Heart Failure
  • Follow-Up Studies
  • Female
  • Echocardiography
  • Diabetes Mellitus
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Gori, M., Canova, P., Calabrese, A., Cioffi, G., Trevisan, R., De Maria, R., … Senni, M. (2017). Strategy to identify subjects with diabetes mellitus more suitable for selective echocardiographic screening: The DAVID-Berg study. Int J Cardiol, 248, 414–420. https://doi.org/10.1016/j.ijcard.2017.06.101
Gori, Mauro, Paolo Canova, Alice Calabrese, Giovanni Cioffi, Roberto Trevisan, Renata De Maria, Aurelia Grosu, et al. “Strategy to identify subjects with diabetes mellitus more suitable for selective echocardiographic screening: The DAVID-Berg study.Int J Cardiol 248 (December 1, 2017): 414–20. https://doi.org/10.1016/j.ijcard.2017.06.101.
Gori M, Canova P, Calabrese A, Cioffi G, Trevisan R, De Maria R, et al. Strategy to identify subjects with diabetes mellitus more suitable for selective echocardiographic screening: The DAVID-Berg study. Int J Cardiol. 2017 Dec 1;248:414–20.
Gori, Mauro, et al. “Strategy to identify subjects with diabetes mellitus more suitable for selective echocardiographic screening: The DAVID-Berg study.Int J Cardiol, vol. 248, Dec. 2017, pp. 414–20. Pubmed, doi:10.1016/j.ijcard.2017.06.101.
Gori M, Canova P, Calabrese A, Cioffi G, Trevisan R, De Maria R, Grosu A, Iacovoni A, Fontana A, Ferrari P, Greene SJ, Gheorghiade M, Parati G, Gavazzi A, Senni M. Strategy to identify subjects with diabetes mellitus more suitable for selective echocardiographic screening: The DAVID-Berg study. Int J Cardiol. 2017 Dec 1;248:414–420.
Journal cover image

Published In

Int J Cardiol

DOI

EISSN

1874-1754

Publication Date

December 1, 2017

Volume

248

Start / End Page

414 / 420

Location

Netherlands

Related Subject Headings

  • Risk Factors
  • Prospective Studies
  • Middle Aged
  • Male
  • Humans
  • Heart Failure
  • Follow-Up Studies
  • Female
  • Echocardiography
  • Diabetes Mellitus