Abstract
Background: Heart failure is the commonest cardiovascular complication in type 2 diabetes mellitus. However, subclinical left ventricular dysfunction can’t be detected using 2D echocardiography which is routinely used for cardiac evaluation of diabetic patients. We aimed to determine the prevalence and factors associated to left ventricular global longitudinal strain (LV GLS) impairment in type 2 diabetes Cameroonians patients. Methods: We conducted a cross-sectional study from January 2019 to June 2019, including type 2 diabetes patients with preserved left ventricle ejection fraction. Clinical and echocardiographic data were collected, and LV GLS was assessed using speckle tracking technique, a value ≤ -16% been considered as normal value. Results: We recruited 95 patients, with a mean age of 57.4 ± 11.8 years old and median diabetes duration of 5 [2 - 12] years. Echocardiographic evaluation found 56.3% of left ventricle remodelling, 51.6% of left ventricle diastolic dysfunction and mean left ventricle ejection of 63.3% ± 6.6%. LV GLS impairment was present in 43.2% (95% CI: 32.6 - 53.7) of the participants. After adjustment to all significantly associated factors, Obesity (aOR: 4; 95% CI: 1.5 - 10.6) and diastolic dysfunction (aOR: 3.1; 95% CI: 1.2 - 8.2) were independent factors associated with LV GLS. Conclusions: Subclinical systolic dysfunction assessed by LV GLS impairment is frequent in diabetic patients. Further research should be carried out more extensively to integrate LV GLS in the type 2 diabetes patients’ routine follow up for a better prognostic outcome, especially in low-incomes countries.
Highlights
Type 2 diabetes is the pathology susceptible to lead to multi organ dysfunction including the heart failure (HF) [1]
After adjustment to all significantly associated factors, Obesity and diastolic dysfunction were independent factors associated with left ventricular (LV) global longitudinal strain (GLS)
LV longitudinal myocardial systolic dysfunction has been shown to be the first marker of a preclinical form of diabetic cardiomyopathy in diabetic patients with preserved left ventricular ejection fraction (LVEF) without overt HF [8]
Summary
Type 2 diabetes is the pathology susceptible to lead to multi organ dysfunction including the heart failure (HF) [1]. Underlying mechanisms include: altered coronary micro circulation, mitochondrial dysfunction and lipotoxicity [4] [5] All these complications can lead to left ventricular systolic dysfunction in diabetic patients, which is found in 18% of these patients [6]. Speckle tracking echocardiography has been used to assess the global longitudinal strain (GLS) of left ventricle, to detect subclinical systolic dysfunction. We aimed to evaluate the prevalence and factors associated to impaired LV GLS in a population of diabetic patients from a low-income country where speckle tracking echocardiography is not routinely available. We aimed to determine the prevalence and factors associated to left ventricular global longitudinal strain (LV GLS) impairment in type 2 diabetes Cameroonians patients.
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