Detection of early left ventricular and left atrial dysfunction in type I diabetes mellitus using two dimensional speckle tracking echocardiography

Abstract

Background Occult left ventricular (LV) systolic and diastolic dysfunction is not uncommon among young adults with type I diabetes mellitus (T1DM). Early detection in the subclinical phase may enhance different preventive strategies. The two-dimensional speckle tracking echocardiography (2D-STE) is a novel and promising tool for the detection of early changes in LV and left atrial (LA) myocardial performance. Aim To detect early LV and LA dysfunction in young adults with T1DM by 2D-STE and its correlation with their functional capacity using the treadmill stress test. Patients and methods Thirty patients with T1DM and 15 nondiabetics acting as controls were enrolled. Conventional 2D echo, tissue Doppler imaging (TDI), and 2D-STE were done. Peak LV global longitudinal strain and peak LA global longitudinal strain were obtained. The functional capacity was assessed using the treadmill stress test. Results A statistically significant decrease in the average peak LV global longitudinal strain was found in diabetics compared to nondiabetics (15.8±6.8 and 23.9±2.7, respectively; P<0.001) and in LV TDI strain rate (19.7±5.4 and 23±2.7, respectively® P<0.05) were found. A statistically significant peak atrial longitudinal strain decrease in the average in diabetics compared to nondiabetics (34.40±12.9 and 42.3±3.9, respectively, P<0.05). There were no significant differences between the two groups with respect to the functional capacity of the parameters. Conclusion Since T1DM is associated with early (subclinical) LV and LA dysfunction, 2D-STE becomes an important and sensitive tool for an early detection of subclinical LV and LA myocardial dysfunction.