Abstract
s S27 Eur J Echocardiography Abstracts Supplement, December 2006 251 Atrial strain (S), strain rate (SR) and diastolic function study in diabetic population without coronary artery disease C.P. Caso Pio 1 ; C.P.S. Comenale Pinto Salvatore 1 ; R.A. Ancona Roberta 1 ; D.R.M.L. De Rimini Maria Luisa 1 ; S.S. Severino Sergio 1 ; P.F. Pisacane Francesca 1 ; M.A.M. Macrino Mariangela 1 ; R.C. Calabro’ Raffaele 1 1A. O. Monaldi, Cardiology Dept., Naples, Italy Background: Abnormalities in diastolic function are considered to be an early sign of diabetic (DM) cardiomyopathy in patients without systolic ventricular dysfunction. Echocardiography with Doppler measurements of transmitral and transtricuspidal flow, together with myocardial tissue Doppler (DTI), Strain (S) and Strain rate (SR) are means to evaluate diastolic function noninvasively. Aim of study: To compare left (LV) and right (RV) ventricular systolic and diastolic function, assessed by conventional echocardiography and by DTI and atrial function assessed by S and SR, in DM patients without coronary artery disease (CAD) and non-diabetic subjects. Methods: We studied 30 subjects: 15 diabetic patients (7 M, 8 F, mean age: 54 years) without CAD, assessed by negative coronary angiography or myocardial scintigraphy and 15 controls. By Echocardiography System Seven GE equipped with TVI function we studied LV and RV systolic and diastolic function, pulmonary artery wedge pressure (PCWP), calculated by E/Ea and left and right atrial (LA/RA) peak systolic tissue S and SR in 4 and 2 chambers view, at the level of the apical segment of the septal, lateral, anterior and inferior LA walls, and RA free wall. We studied by Pulsed Doppler and DTI early (E) and late (A) diastolic wave velocity, ratio E/A, deceleration time (DT); left and right isovolumic relaxation time (IVRT) and Pulsed Doppler of pulmonary vein flow. Results: There were differences in flow parameters: DM patients had significantly higher prevalences of abnormal diastolic mitral (ratio E/A=0.83 vs 1.2) and tricuspidal (ratio E/A=0.85 vs 1.4) flow patterns than the non-diabetic patients and a significantly longer mitral valve DT (245 versus 195 msec). Although no differences were found in LA/RA diameters and volumes, the myocardial atrial S and SR were found to be significantly (p=0.002) lower for atrial septum, RA free wall and LA anterior wall in DM patients than in controls. Instead no differences were found in DM and non-diabetic patients for systolic LV function (EF=60% vs 64%), IVRT (91 vs ?90 msec), propagation velocity of transmitral flow during early ventricular filling (Vp=78.93 vs 80.12 cm/sec) and PCWP (11.87 vs 10.21 mm Hg). Conclusions: LA/RA S and SR are compromised in DM patients. Left and right diastolic function abnormalities in DM population with normal systolic function, without DM complications, hypertension and CAD, has been suggested as an earliest functional effect of a specific DM cardiomyopathy. Thus, diastolic LV and RV function in DM population are impared independently of CAD.
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