• Mi Zhou, Duo Huang, Yangyang Cheng, Yee Man Lau, Wing Hon Lai, Yuk-Ming Lau, JoJo Hai, Chu Pak Lau, Esther W Chan, Wen Sheng Yue, Ming-Liang Zuo, Li Xue Yin, Yingqing Feng, Ning Tan, Jiyan Chen, Xin Li Li, Hung Fat Tse, Chi Ho Lee, Wing-Sun Chow, Chung Wah Siu, and Chun Ka Wong.
• Cardiology Division, Department of Medicine, University of Hong Kong, Hong Kong, Hong Kong.
• Postgrad Med J. 2022 Mar 8.

BackgroundInternational guidelines recommend natriuretic peptide biomarker-based screening for patients at high heart failure (HF) risk to allow early detection. There have been few reports about the incorporation of screening procedure to existing clinical practice.ObjectiveTo implement screening of left ventricular dysfunction in patients with type 2 diabetes mellitus (DM).MethodA prospective screening study at the DM complication screening centre was performed.ResultsBetween 2018 and 2019, 1043 patients (age: 63.7±12.4 years; male: 56.3%) with mean glycated haemoglobin of 7.25%±1.34% were recruited. 81.8% patients had concomitant hypertension, 31.1% had coronary artery disease, 8.0% had previous stroke, 5.5% had peripheral artery disease and 30.7% had chronic kidney disease (CKD) stages 3-5. 43 patients (4.1%) had an elevated N-terminal prohormone of brain natriuretic peptide (NT-proBNP) concentration above the age-specific diagnostic thresholds for HF, and 43 patients (4.1%) had newly detected atrial fibrillation (AF). The prevalence of elevated NT-proBNP increased with age from 0.85% in patients aged <50 years to 7.14% in those aged 70-79 years and worsening kidney function from 0.43% in patients with CKD stage 1 to 42.86% in CKD stage 5. In multivariate logistic regression, male gender (OR: 3.67 (1.47-9.16), p = 0.005*), prior stroke (OR: 3.26 (1.38-7.69), p = 0.007*), CKD (p<0.001*) and newly detected AF (OR: 7.02 (2.65-18.57), p<0.001*) were significantly associated with elevated NT-proBNP. Among patients with elevated NT-proBNP, their mean left ventricular ejection fraction (LVEF) was 51.4%±14.7%, and 45% patients had an LVEF <50%.ConclusionNT-proBNP and ECG screening could be implemented with relative ease to facilitate early detection of cardiovascular complication and improve long-term outcomes.© The Author(s) 2022. Published by Oxford University Press on behalf of Postgraduate Medical Journal. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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