Left ventricular function in hypertensive diabetic patients in Morocco: Overall longitudinal strain and diastolic function

Abstract

Type 2 diabetes is a major risk factor for congestive heart failure. Recent data judge that a decrease in left ventricular longitudinal myocardial deformity as well as diastolic dysfunction are apparent in the early stages of diabetic cardiomyopathy and this regardless of the presence of hypertension in type 2 diabetic patients. The objective of this study was to characterize left ventricular function in hypertensive patients with type 2 diabetes with a normal ejection fraction and to relate these results to pathogenic cardiovascular risk factors. A prospective study carried out at the Ibn Rochd University Hospital in Casablanca between March 2019 and March 2021, including hypertensive diabetics, with a duration of the two diseases greater than 1 year without coronary heart disease, or low left ventricular fraction ejection. We performed laboratory workup including microalbuminuria, glycated hemoglobin, ECG, echocardiography, and 24 hour ambulatory blood pressure. To the diabetic group was added a group of non-diabetic hypertensive controls. Diabetic patients had significantly higher blood pressure, compared to the control group. Left atrium, mitral A wave velocity, and left ventricular mass were significantly higher in subjects with diabetes, and the E/A ratio was significantly lower than in control subjects. In 22.22% of hypertensive diabetic patients, an alteration in SGL was observed versus 9.5% in the control group. In the group of diabetic patients, SGL was significantly correlated with left ventricular mass, and uncontrolled glycated hemoglobin Patients with diastolic dysfunction had significantly higher levels of microalbuminuria, heart rate and nondipper blood pressure. Longitudinal systolic deformity was linked in hypertensive diabetic patients to left ventricular mass and glycated hemoglobin level, as well as diastolic dysfunction is mainly linked to microalbuminuria.