Effect of short-term insulin pump therapy on left ventricular systolic function in type 2 diabetes mellitus patients evaluated by three-dimensional speckle tracking imaging

Abstract

Objective To assess the improvements of left ventricular systolic function by three-dimensional speckle tracking imaging (3D-STI) in type 2 diabetes mellitus (T2DM) patients after short-term insulin pump intensive therapy. Methods Thirty-five T2DM patients complicated with microangiopathy and thirty-two healthy volunteers were studied, underwent the dynamic image of the four-chamber view, three-dimensional images of left ventricle were obtained for all the individuals. The left ventricular global longitudinal strain (LVGLS), left ventricular global circumferential strain (LVGCS), left ventricular ejection fraction (LVEF), peak basal and apical rotation (LV-ProtB, LV-ProtA), peak LV twist (LV-tw ) were calculated using TomTec software.After insulin pump intensive therapy for two weeks, all the indexes were reexamined in T2DM patients. Results Compared with control group, the LVGLS, LVGCS, LV-tw and LV-ProtA were significantly decreased in diabetes mellitus group before and after treatment (P<0.01 or P<0.05). Compared with diabetes mellitus patients before treatment, the LVGLS, LVGCS had significant higher level after treatment(P<0.05). The LVGLS, LVGCS, LV-tw and LV-ProtA were significantly correlated with LVEF in type 2 diabetes mellitus patients and normal controls. Conclusions Insulin pump intensive treatment could improve left ventricular systolic function in type 2 diabetes patients complicated with microangiopathy. 3D-STI can be sensitive to accurately assess the therapeutic effect and has the important clinical value. Key words: Echocardiography; Type 2 diabetes mellitus; Insulin pump intensive therepy; Three dimensional speckle tracking imaging