Abstract
BackgroundCoexistence of left ventricular (LV) longitudinal myocardial systolic dysfunction with LV diastolic dysfunction could lead to heart failure with preserved ejection fraction (HFpEF). Diabetes mellitus (DM) is known as a significant factor associated with HFpEF. Although the mechanisms of DM-related LV myocardial injury are complex, it has been postulated that overweight contributes to the development of LV myocardial injury in type 2 diabetes mellitus (T2DM) patients. However, the precise impact of overweight on LV longitudinal myocardial systolic function in T2DM patients remains unclear.MethodsWe studied 145 asymptomatic T2DM patients with preserved LV ejection fraction (LVEF) without coronary artery disease. LV longitudinal myocardial systolic function was assessed by global longitudinal strain (GLS), which was defined as the average peak strain of 18-segments obtained from standard apical views. Overweight was defined as body mass index (BMI) ≥ 25 kg/m2. Ninety age-, gender- and LVEF-matched healthy volunteers served as controls.ResultsGLS of overweight T2DM patients was significantly lower than that of non-overweight patients (17.9 ± 2.4% vs. 18.9 ± 2.6%, p < 0.05), whereas GLS of both overweight and non-overweight controls was similar (19.8 ± 1.3% vs. 20.4 ± 2.1%, p = 0.38). Furthermore, multiple regression analysis revealed that for T2DM patients, BMI was the independent determinant parameters for GLS as well as LV mass index.ConclusionsOverweight has a greater effect on LV longitudinal myocardial systolic function in T2DM patients than on that in non-DM healthy subjects. Our finding further suggests that the strict control of overweight in T2DM patients may be associated with prevention of the development of HFpEF.
Highlights
Heart failure (HF) with preserved ejection fraction (HFpEF), which is determined as the presence of HF symptoms and signs with left ventricular ejection fraction (LVEF) ≥ 50% [1], currently accounts for roughly half of all HF cases and its prevalence is related to HF with reduced ejection fraction (HFrEF)
Clinical data showed that the prevalence of dyslipidemia in type 2 diabetes mellitus (T2DM) patients with overweight was higher than in those without overweight, while echocardiographic data showed that T2DM patients with overweight had a higher LV mass index and lower global longitudinal strain (GLS) compared to those without overweight
The findings of the present study indicate that LV longitudinal myocardial systolic function in T2DM patients with overweight was significantly worse than that in T2DM patients without overweight, whereas, no such finding was obtained for age, gender, and LVEF-matched controls
Summary
Heart failure (HF) with preserved ejection fraction (HFpEF), which is determined as the presence of HF symptoms and signs with left ventricular ejection fraction (LVEF) ≥ 50% [1], currently accounts for roughly half of all HF cases and its prevalence is related to HF with reduced ejection fraction (HFrEF). It has been postulated that overweight contributes to the development of LV myocardial injury in DM patients, but the precise impact of overweight on LV function is not yet fully understood. The aim of this study was to investigate the effect of overweight on LV longitudinal myocardial systolic function in asymptomatic patients with type 2 DM (T2DM) with preserved LVEF but without coronary artery disease. Coexistence of left ventricular (LV) longitudinal myocardial systolic dysfunction with LV diastolic dysfunction could lead to heart failure with preserved ejection fraction (HFpEF). The mechanisms of DM-related LV myocardial injury are complex, it has been postulated that overweight contributes to the development of LV myocardial injury in type 2 diabetes mellitus (T2DM) patients. The precise impact of overweight on LV longitudinal myocardial systolic function in T2DM patients remains unclear
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