Longitudinal strain bull’s eye plot patterns in young women with type 1 diabetes – association of regional cardiac systolic function with thyroid autoimmunity and iron status

Abstract

IntroductionAlthough heart failure (HF) in diabetes develops insidiously and affects even young people especially those with type 1 diabetes (T1DM), there is still lack of non-invasive methods to facilitate its early diagnosis. The main aims of this pilot study were to evaluate early left ventricular (LV) segmental changes in young women with T1DM and to determine if they correlate with Hashimoto’s thyroiditis (HT) and iron or ferritin serum levels.Material and methodsThirty women with T1DM (20 of whom had HT) and 30 age-matched controls included in the study underwent medical interview, laboratory tests (serum iron and ferritin levels, glycated hemoglobin, lipid and thyroid profile) and echocardiography using two-dimensional speckle tracking imaging.ResultsWomen with T1DM had significantly reduced longitudinal strain (LS) in the basal and medial anterior and anterolateral segments (p=0.022, p=0.010, respectively) and basal inferior and inferolateral segments than controls (p= 0.035). The significant correlation were found between global and medial anterior and anterolateral LS and HT duration (r=-0.366, p=0.046, r=-0.411, p=0.024, respectively), basal inferolateral LS and iron levels (r=0.404, p=0.027) and medial anteroseptal and inferoseptal LS and ferritin levels (r=-0.498, p=0.005).ConclusionsThe LS bull's eye plot pattern appears to be a non-invasive method for identifying early changes in contractile function, which in women with T1DM are characterized by lesions in basal and medial parts of anterior and anterolateral segments and basal inferior and inferolateral segments. Moreover, part of these changes may be correlated with longer duration of HT and lower serum iron levels.