Abstract
Background: Type 2 diabetes mellitus (T2DM) is a common risk factor for cardiovascular diseases. The aims of this study were to evaluate the changes in the left ventricular myocardial work in T2DM patients using the left ventricular pressure-strain loop (PSL) technique, and to explore the risk factors for the left ventricular myocardial work impairment.Methods: Fifty patients with T2DM and 50 normal controls (NCs) were included in the study. In addition to conventional echocardiography and two-dimensional speckle tracking echocardiography, the left ventricular myocardial work parameters were measured using PSL technology.Results: The absolute value for global longitudinal strain (GLS), global work index (GWI) and, global constructive work (GCW) were significantly decreased in the T2DM group (P < 0.05), while the left ventricular ejection fraction (LVEF) was not significantly different between the T2DM and NC groups. Multivariable linear regression analysis showed that hemoglobin A1c (HbA1c) was independently related to GWI (β = −0.452, P < 0.05), while HbA1c and the diabetes duration were independently related to GCW (β = −0.393, P < 0.05 and β = −0.298, P < 0.05, respectively).Conclusions: Changes in the left ventricular myocardial systolic function in T2DM patients were identified using PSL technology. HbA1c was shown to be an independent risk factor affecting GWI, while HbA1c and diabetes duration were demonstrated to be independent risk factors affecting GCW.
Highlights
Diabetes is a common clinical metabolic disease
Body mass index (BMI), body surface area (BSA), hemoglobin A1c (HbA1c), TG, and low-density lipoprotein cholesterol (LDL-C) in the Type 2 diabetes mellitus (T2DM) group were significantly increased compared to the normal control (NC) group (P < 0.05) (Table 1)
There were no significant differences in gender, age, heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), Total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and smoking history between the two groups (P > 0.05)
Summary
Diabetes is a common clinical metabolic disease. Type 2 diabetes mellitus (T2DM) accounts for more than 90% of diabetic patients [1]. A new non-invasive left ventricular pressure-strain loop (PSL) technology has been developed based on two-dimensional speckle tracking technology to assess the changes in left ventricular myocardial function. Hubert et al invasively measured the left ventricular pressure in patients implanted with a bi-ventricular pace-maker, and blood pressure was measured by brachial artery cuff-pressure for estimating the left ventricular pressure They found that the maximum systolic value was different between measured and estimated pressures, but the estimated and measured PSL and global myocardial work indices were strongly correlated, with an R2 > 0.88. Type 2 diabetes mellitus (T2DM) is a common risk factor for cardiovascular diseases. The aims of this study were to evaluate the changes in the left ventricular myocardial work in T2DM patients using the left ventricular pressure-strain loop (PSL) technique, and to explore the risk factors for the left ventricular myocardial work impairment
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