963 Left ventricle myocardial function in hypertensive patients with combined diabetes mellitus according to pulsed wave tissue doppler imaging

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s S167 Eur J Echocardiography Abstracts Supplement, December 2006 diastolic dysfunction over and beyond of what is caused by DM alone. The aim of the present study was to investigate whether MA causes additional myocardial functional disturbances in patients with DM. Methods: 39 non-consecutive, age-matched, human subjects (14 DM without MA, Group; 15 DM with MA, Group 2; 10 normal controls, Group 3) underwent tissue Doppler (TVE) -enhanced dobutamine stress echocardiography. The DM subjects had no prior history of cardiac events and were asymptomatic. Biochemical data along with HBA1c (%) and urinary microalbumin (UAE, μg/L) were obtained using standard methods. Stress images were post-processed on Echopac software (GE) to obtain the TVE variables viz., peak systolic (PSV) & early (E ) diastolic velocities (cm/s). Isovolumic contraction (IVCT), relaxation (IVRT) and ejection (ET) times (msec) were measured to obtain Tei index using the formula (IVCT+IVRT)/ET in order to assess global myocardial performance. The TVE data were obtained from 4 LV bases. ANOVA followed by Tukey Honest test was performed to compare the groups while unpaired t test was performed to compare the DM groups. p<0.05 was considered statistically significant. Results: Average age of the patients were 50±6 years. All DM subjects were on oral medications. Fasting plasma glucose, mg/dl, (184±13 vs 203±11), and HbA1c (8.0±0.7 vs 8.1±0.6) did not differ between Group 1&2. UAE (μg/l) was significantly higher in Group 2 (100±10) compared with Group 1 (6.7±2.5; p<0.001). PSV (cm/s) at rest in the LV lateral wall was lowest in Group 2 (4.7±1.1) that differed both from Group 1 (5.6±1.2) and Group 3 (5.8±1.4) (all p<0.05). At peak stress PSV was significantly higher in septum in Group 3 (13.8±2.1) compared with Group 1 (11.1±1.6) and Group 2 (10.0±1.5) (all p<0.001), without any difference between Group 1&2. Similar PSV response to stress was also noted in other LV walls. E velocity was significantly lower in the DM groups in all LV walls both at rest as well as during peak stress, without any difference between the DM subjects. Tei index was significantly higher in Group 1 (0.52±0.1 vs 0.40±0.2; p<0.05) compared with Group 3, without any difference in DM subjects. Conclusions: TVEdefined LV dysfunctions are common in subjects with DM irrespective of the presence of microalbuminuria.