Volume : 5, Issue : 12, December - 2016

CORRELATION OF HBA1C LEVELS TO DIASTOLIC DYSFUNCTION ASSESED BY ECHOCARDIOGRAPHY IN STROKE PATIENTS.

K. Praveen, C. Raghuram

Abstract :

<p>&nbsp;<b><u><span style="font-size:18.0pt;line-height:110%;&#10;color:#0673A5;mso-themecolor:text2;mso-themeshade:191">AIMS</span></u></b><b><span style="font-size:18.0pt;line-height:110%;color:#0673A5;mso-themecolor:text2;&#10;mso-themeshade:191"> </span></b><b><span style="font-size:22.0pt;line-height:&#10;110%;color:#0673A5;mso-themecolor:text2;mso-themeshade:191">:</span></b></p> <p class="MsoListParagraphCxSpFirst" style="text-indent:-.25in;mso-list:l2 level1 lfo1"><!--[if !supportLists]--><span style="font-size:12.0pt;line-height:110%;font-family:Wingdings;mso-fareast-font-family:&#10;Wingdings;mso-bidi-font-family:Wingdings">v<span style="font-variant-numeric: normal; font-stretch: normal; font-size: 7pt; line-height: normal; font-family: &quot;Times New Roman&quot;;">&nbsp; </span></span><!--[endif]--><span style="font-size:12.0pt;line-height:110%">Assess the level of HbA1c in relation to stroke.<o:p></o:p></span></p> <p class="MsoListParagraphCxSpLast" style="text-indent:-.25in;mso-list:l2 level1 lfo1"><!--[if !supportLists]--><span style="font-size:12.0pt;line-height:110%;font-family:Wingdings;mso-fareast-font-family:&#10;Wingdings;mso-bidi-font-family:Wingdings">v<span style="font-variant-numeric: normal; font-stretch: normal; font-size: 7pt; line-height: normal; font-family: &quot;Times New Roman&quot;;">&nbsp; </span></span><!--[endif]--><span style="font-size:12.0pt;line-height:110%">To determine the relationship between HbA1c and diastolic dysfunction in stroke patients.<o:p></o:p></span></p> <p class="MsoNormal"><b><u><span style="font-size:18.0pt;line-height:110%;&#10;color:#0673A5;mso-themecolor:text2;mso-themeshade:191">METHODS :<o:p></o:p></span></u></b></p> <p class="MsoListParagraphCxSpFirst"><span style="font-size:12.0pt;line-height:&#10;110%">A cross-sectional hospital-based study was done which included 50 patients with stroke. Diastolic dysfunction was evaluated by Doppler echocardiography, in relation with age/sex &nbsp;&nbsp;and HbA1c level in these patients. Data compiled &amp; analysed in Microsoft Excel 2013 &amp; Predictive analytics Software (SPSS) Vr. 11. Results shown in Frequencies and proportions. Sample&nbsp; &nbsp;&lsquo;t&rsquo; Significance tests applied. All stroke cases admitted in the department of General Medicine, ASRAMS, Eluru ,Andhra Pradesh, India between July 2015 to october 2016 were taken for the study.<o:p></o:p></span></p> <p class="MsoListParagraphCxSpMiddle"><span style="font-size:12.0pt;line-height:&#10;110%">&nbsp;</span></p> <p class="MsoListParagraphCxSpMiddle" style="margin-left:0in;mso-add-space:auto"><b><u><span style="font-size:18.0pt;line-height:110%;color:#0673A5;mso-themecolor:text2;&#10;mso-themeshade:191">RESULTS :<o:p></o:p></span></u></b></p> <p class="MsoListParagraphCxSpMiddle"><span style="font-size:12.0pt;line-height:&#10;110%">&nbsp;</span></p> <p class="MsoListParagraphCxSpMiddle" style="margin-left:1.0in;mso-add-space:&#10;auto;text-indent:-.25in;mso-list:l1 level1 lfo2"><!--[if !supportLists]--><span style="font-size:12.0pt;line-height:110%;font-family:Wingdings;mso-fareast-font-family:&#10;Wingdings;mso-bidi-font-family:Wingdings">v<span style="font-variant-numeric: normal; font-stretch: normal; font-size: 7pt; line-height: normal; font-family: &quot;Times New Roman&quot;;">&nbsp; </span></span><!--[endif]--><span style="font-size:12.0pt;line-height:110%">The study showed that 74% of stroke patients had diastolic dysfunction.<o:p></o:p></span></p> <p class="MsoListParagraphCxSpLast" style="margin-left:1.0in;mso-add-space:auto;&#10;text-indent:-.25in;mso-list:l1 level1 lfo2"><!--[if !supportLists]--><span style="font-size:12.0pt;line-height:110%;font-family:Wingdings;mso-fareast-font-family:&#10;Wingdings;mso-bidi-font-family:Wingdings">v<span style="font-variant-numeric: normal; font-stretch: normal; font-size: 7pt; line-height: normal; font-family: &quot;Times New Roman&quot;;">&nbsp; </span></span><!--[endif]--><span style="font-size:12.0pt;line-height:110%">20 % &nbsp;&nbsp;and 70 % were categorized as pre diabetic and diabetics respectively on the basis of HbA1c levels.<o:p></o:p></span></p> <p class="MsoNormal"><b><u><span style="font-size:18.0pt;line-height:110%;&#10;color:#0673A5;mso-themecolor:text2;mso-themeshade:191">&nbsp;</span></u></b></p> <p class="MsoNormal"><b><u><span style="font-size:18.0pt;line-height:110%;&#10;color:#0673A5;mso-themecolor:text2;mso-themeshade:191">&nbsp;</span></u></b></p> <p class="MsoNormal"><b><u><span style="font-size:18.0pt;line-height:110%;&#10;color:#0673A5;mso-themecolor:text2;mso-themeshade:191">CONCLUSIONS :</span></u></b><span style="font-size:12.0pt;line-height:110%"><o:p></o:p></span></p> <p class="MsoListParagraphCxSpFirst" style="text-indent:-.25in;mso-list:l0 level1 lfo3"><!--[if !supportLists]--><span style="font-size:12.0pt;line-height:110%;font-family:Wingdings;mso-fareast-font-family:&#10;Wingdings;mso-bidi-font-family:Wingdings">v<span style="font-variant-numeric: normal; font-stretch: normal; font-size: 7pt; line-height: normal; font-family: &quot;Times New Roman&quot;;">&nbsp; </span></span><!--[endif]--><span style="font-size:12.0pt;line-height:110%">This Study demonstrated a highly significant (positive) correlation between HbA1C level and frequency of diastolic dysfunction in stroke patients.<o:p></o:p></span></p> <p class="MsoListParagraphCxSpMiddle" style="text-indent:-.25in;mso-list:l0 level1 lfo3"><!--[if !supportLists]--><span style="font-size:12.0pt;line-height:110%;font-family:Wingdings;mso-fareast-font-family:&#10;Wingdings;mso-bidi-font-family:Wingdings">v<span style="font-variant-numeric: normal; font-stretch: normal; font-size: 7pt; line-height: normal; font-family: &quot;Times New Roman&quot;;">&nbsp; </span></span><!--[endif]--><span style="font-size:12.0pt;line-height:110%">Higher HbA1c level is a reliable predictor of diastolic dysfunction in stroke patients.<o:p></o:p></span></p> <p class="MsoListParagraphCxSpMiddle" style="text-indent:-.25in;mso-list:l0 level1 lfo3"><!--[if !supportLists]--><span style="font-size:12.0pt;line-height:110%;font-family:Wingdings;mso-fareast-font-family:&#10;Wingdings;mso-bidi-font-family:Wingdings">v<span style="font-variant-numeric: normal; font-stretch: normal; font-size: 7pt; line-height: normal; font-family: &quot;Times New Roman&quot;;">&nbsp; </span></span><!--[endif]--><span style="font-size:12.0pt;line-height:110%">Hence we recommend HbA1c level as an independent predictor of stroke.<o:p></o:p></span></p> <p class="MsoListParagraphCxSpMiddle" style="text-indent:-.25in;mso-list:l0 level1 lfo3"><!--[if !supportLists]--><span style="font-size:12.0pt;line-height:110%;font-family:Wingdings;mso-fareast-font-family:&#10;Wingdings;mso-bidi-font-family:Wingdings">v<span style="font-variant-numeric: normal; font-stretch: normal; font-size: 7pt; line-height: normal; font-family: &quot;Times New Roman&quot;;">&nbsp; </span></span><!--[endif]--><span style="font-size:12.0pt;line-height:110%">Doppler Echocardiography is a simple noninvasive valuable tool in diagnosing diastolic dysfunction.<o:p></o:p></span></p> <p class="MsoListParagraphCxSpMiddle" style="text-indent:-.25in;mso-list:l0 level1 lfo3"><!--[if !supportLists]--><span style="font-size:12.0pt;line-height:110%;font-family:Wingdings;mso-fareast-font-family:&#10;Wingdings;mso-bidi-font-family:Wingdings">v<span style="font-variant-numeric: normal; font-stretch: normal; font-size: 7pt; line-height: normal; font-family: &quot;Times New Roman&quot;;">&nbsp; </span></span><!--[endif]--><span style="font-size:12.0pt;line-height:110%">Diabetic patients have higher tendency to develop Diastolic dysfunction which is usually undiagnosed.<o:p></o:p></span></p> <p class="MsoListParagraphCxSpLast" style="text-indent:-.25in;mso-list:l0 level1 lfo3"><!--[if !supportLists]--><span style="font-size:14.0pt;line-height:110%;font-family:Wingdings;mso-fareast-font-family:&#10;Wingdings;mso-bidi-font-family:Wingdings">v<span style="font-variant-numeric: normal; font-stretch: normal; font-size: 7pt; line-height: normal; font-family: &quot;Times New Roman&quot;;"> </span></span><!--[endif]--><span style="font-size:12.0pt;line-height:110%">Thus, early Echocardiography is advised in all diabetics to assess the cardiac function</span><span style="font-size:14.0pt;line-height:110%"><o:p></o:p></span></p>