Association between Newly Diagnosed Type 2 Diabetes Mellitus and Left Ventricular Global Longitudinal Strain: A Single Center, Cross-Sectional Study

Abstract

Objective: Diabetes mellitus is a major cardiovascular risk factor. Diabetic complications in the cardiovascular system randomly appear following long standing diabetes. However, newly diagnosed diabetes can also be associated with cardiac problems. The aim of this study was to compare patients with newly diagnosed type 2 diabetes mellitus (T2DM) to healthy controls in regard to echocardiography features, specifically left ventricular global longitudinal strain (LV GLS). Materials and methods: This was a prospective crosssectional study conducted on 94 patients, 52 patients with newly diagnosed T2DM that formed the first group and 42 healthy subjects, without history of diabetes mellitus and/or cardiovascular disease, which formed the second group. Results: Patients with newly diagnosed T2DM had mean glucose level of 16.37 ± 7.43 mmol/L and HbA1c of 8.57 ± 2.31 %. The groups did not differ in regard to age, gender, smoking, arterial hypertension or heart rate at the time of examination. The ratio between early mitral inflow velocity and mitral annular early diastolic velocity (E/e’) of the septal wall was significantly lower in patients with newly diagnosed T2DM (6.21 ± 3.14 vs. 7.8 ± 2.45, p = 0.009). The LV GLS resulted lower in patients with newly diagnosed T2DM compared to the healthy subjects (|–19.36|% ± 2.98 vs. |–20.43|% ± 1.99. p = 0.049). Of note, the LV GLS values are expressed as absolute numbers. The ratio of patients with LV GLS strain < |–18.8|% was significantly higher in patients with newly diagnosed T2DM (42.31% vs. 21.43%, p = 0.03). Conclusions: LV GLS may serve as an important echocardiographic parameter to detect early myocardial changes in asymptomatic patients with newly diagnosed T2DM.