Abstract
Several studies have shown that left ventricular (LV) dysfunction is increased in individuals with diabetes. However, there are scarce data about LV function in prediabetics. This study assessed the early changes in LV diastolic and systolic myocardial function in normotensive prediabetics using tissue Doppler echocardiography (TDE). We evaluated 94 patients with prediabetes (mean age of 50.8 ± 6.9 years, 78 female) without known cardiovascular diseases and 70 healthy volunteers with similar demographic characteristics. Systolic and diastolic function of the left ventricle was evaluated with transthoracic echocardiography according to the latest consensus recommendations including TDE. The mean results of septal and lateral parts of the mitral annulus Pulsed wave TDE showed that myocardial systolic wave (Sm), myocardial early diastolic wave (Em) and Em to atrial peak velocity (Am) ratio were significantly lower whereas early diastolic peak flow velocity (E) to Em ratio, myocardial isovolumetric relaxation time (IVRTm), myocardial isovolumetric contraction time (IVCTm) and myocardial performance index (MPI) values were significantly higher in patients with prediabetes (preDM). In addition, mean left atrium (LA) diameter measured with M-mode echocardiography was significantly higher in prediabetics than controls. PreDM is associated with subclinical LV systolic and diastolic dysfunction as evaluated by TDE.
Highlights
T ype 2 diabetes affects more than 8% of the United States population [1]
The diagnosis of PreDM was ensured according to the fasting plasma glucose (FPG) level and/or oral glucose tolerance test (OGTT) results confirmed by repeating the tests on another day and/ or measuring the HbA1c level based on American Diabetes Association (ADA) guidelines [1,2]
We have found that patients with preDM have both impaired left ventricular (LV) systolic and diastolic function
Summary
T ype 2 diabetes affects more than 8% of the United States population [1]. The onset of type 2 diabetes is gradual, with most patients progressing through a state of prediabetes which is defined as one or more of the following: impaired fasting glucose (IFG) (plasma glucose of 100 to 125 mg/dL), impaired glucose tolerance (IGT) (plasma glucose of 140 to 199 mg/dL 2 hours after an oral load of 75 g dextrose) or HbA1c 5.7% to 6.4% [2]. The diagnosis of PreDM was ensured according to the FPG level and/or oral glucose tolerance test (OGTT) results confirmed by repeating the tests on another day and/ or measuring the HbA1c level based on American Diabetes Association (ADA) guidelines [1,2]. All echocardiographic examinations were carried out using 2.5–3.5 MHz transducer with the Vingmed System 7 (Vivid 7, GE, Horten, Norway) by two experienced cardiologists performing the measurements blinded to preDM status MPI was calculated by summing IVCTm and IVRTm and dividing by ETm value In addition to these parameters, E/Em ratio, a reliable index of LV filling pressures was measured. A P-value less than 0.05 was considered statistically significant
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