The Evaluation of Subclinical Left Ventricular Systolic Dysfunction in Prediabetic Patients with a New Echocardiographic Modality (AFI, Automated Function Imaging) Method

Abstract

Objective: Diabetic cardiomyopathy is a major complication of diabetes which has high morbidity and mortality. Diabetic cardiomyopathy is defined as the heart failure resulting from left ventricular systolic and diastolic dysfunction which is independent from factors such as coronary artery disease and hypertension. Prediabetes is known as a strong risk factor for the development of diabetes which needs a long time before formation of diabetes. Early evaluation of cardiac function is important for the prevention of target organ damage in prediabetic individuals. The aim of this study is to evaluate subclinical myocardial dysfunction with a new echocardiographic modalities method, namely speckle tracking echocardiographic method (AFI), in prediabetic patients who has preserved left ventricular systolic function which is evaluated by using conventional echocardiographic method. Methods: 78 subjects (41 with prediabetes and 37 as control) were included in this study. All subjects’ conventional, tissue Doppler and longitudinal strain based on speckle tracking imaging (AFI) data were evaluated by echocardiographic methods. Results: There were no significant differences between the two groups from the aspects of age, gender, smoking, BMI and blood pressure. The mean longitudinal systolic strain values (19,22% 2,68% vs 20,37% 2,02, P1⁄4,034) and the ratio of Em/Ea (1,03 0,22 vs 1,29 0,44, P1⁄4,002) were found significantly lower in prediabetic patients than those in controls, whereas the ratio of E/E’(9,53 2,3 vs 7,61 2,59, P1⁄4,001) was significantly higher. The mean cholesterol (220,22 47,23 vs 191,41 38,83, P1⁄4,005), LDL (147,06 40,43 vs 119,93 32,76, P1⁄4,002) and trigliserid (155,20 107,06 vs 88,11 59,53, P1⁄4,001) levels and the measures of mean height (169,00 8,66 vs 165,11 7,38, P1⁄4,037), weight (78,07 13,31 vs 71,92 13,77, P1⁄4,048) and waist circumference (90,50 9,70 vs 84,70 10,08, P1⁄4,012) were statistically higher in prediabetic patients compared with the ones in control group. Conclusion: The results of this study revealed that the subclinical LV systolic dysfunction may develop also in the period of prediabetes before the development of diabetes. Detection of subclinical LV systolic dysfunction in prediabetic individuals will contribute to determine high-risk groups for the development of diabetes and its complications, and also to specify health policies regarding to take preventive eactions.