A presystolic wave could easily detect subclinical left ventricular dysfunction in prediabetic patients with no history of hypertension.

Abstract

Prediabetes is associated with left ventricular (LV) systolic and diastolic dysfunction. A presystolic wave (PSW) is detected on late diastole from the Doppler examination of the LV outflow tract and is related to LV dysfunction. LV dysfunction could be detected with different echocardiographic methods, including conventional Doppler and Tissue Doppler imaging (TDI), 2D speckle tracking echocardiography, and myocardial performance index (MPI). In this study, we aimed to investigate the association of the presence of PSW with LV dysfunction assessed by different echocardiographic methods. A total of 137 prediabetic normotensive patients were enrolled in this study. Eighty-one (59.1%) patients had a PSW and 36 (40.9%) patients had not PSW on the Doppler examinations. Echocardiographic features were compared between these groups. LV dysfunction was determined based on MPI, LV global longitudinal strain (LVGLS), and conventional Doppler and TDI measurements. There were no differences between groups regarding clinical and laboratory parameters, except LDL, which was significantly higher in the PSW-positive group. The PSW-positive group had lower E, Em, Ea, E/A, Em/Am, Ea/Aa, LVGLS and higher A, Am, Aa, E/e', isovolumetric relaxation time, and MPI than PSW-negatives. PSW velocity was moderately correlated with MPI (R=.33, p=.003) and LVGLS (R=.35, p=.001). The presence of PSW was independently associated with LV dysfunction assessed by MPI (OR=3.87, p<.001), LVGLS (OR=10.29, p<.001), and conventional Doppler and TDI parameters (OR=8.87, p<.001). PSW was significantly associated with subclinical LV dysfunction in prediabetic normotensive patients assessed with three echocardiographic methods.