SUBCLINICAL MYOCARDIAL INJURY OF YOUNG PATIENTS WITH TYPE1 DIABETES MELLITUS WITHOUT CARDIOVASCULAR DISEASE

Abstract

The aim : to study the impact of Type1 Diabetes mellitus (DM) on systolic function of left ventricle (LV) of young patients without cardiovascular disease (CVD) and identify factors associated with dysfunction of global longitudinal systolic deformation. Young patients with Type1 DM (N=71) and without CVD were included in the study. Mean age was 28,7 years, 57% men, glycated hemoglobin 9,9%, body mass index 23,4 kg/m2, and diabetes duration 6,84 [0,5; 24], NT-proBNP 62,62 pg/ml, LV EF 61,7%. Treadmill test was conducted to all patients in order to exclude coronary disease. EchoCG examination including analysis of global longitudinal systolic deformation by two-dimensional image. Subclinical systolic dysfunction, that is defined as GLS<20%, was observed in 63,3% cases. Left ventricle diastolic dysfunction with slow relaxation (Type1) was observed in 5,6% patients with Type1 DM and GLS<20%. The correlation was found for GFR and GLS ( χ 2 12,9, р <0,05, r=0,62). At the same time the relative risk of GLS decreasing with GFR<90ml/min/1,73m2 increased in 2,8 (OR 2,8; 95% CI: 1,4;3,2;p<0,001), with GFR<60ml/min/1,73m2 increased in 3,4 (OR 3,4; 95% CI: 2,3; 4,6; p<0,001). Conclusions: Global longitudinal systolic LV myocardial deformation is a sensitive marker of subclinical myocardial injury of young patients with Type1 DM without CVD.