Abstract
Objectives: This study aimed to quantify left ventricular (LV) myocardial strain and torsion in patients with type 2 diabetes mellitus (T2DM) and evaluate their systolic and diastolic function using conventional and speckle tracking echocardiography.Methods: Forty-seven patients with T2DM were divided into a group without microvascular complications (the DM A group) and a group with microvascular complications (the DM B group), while another 27 healthy participants acted as the control group. All the participants had had an echocardiography examination. All the original data were imported into EchoPAC workstation for the analysis and quantification of LV strain and torsion.Results: Compared with the control group, the LV end-diastolic volume, end-systolic volume, and ejection fraction of the DM A and DM B groups showed no significant differences, but the global longitudinal strain and the global circular strain were reduced in the DM B group. There were significant differences in the left ventricular relative wall thickness (RWT), left ventricular mass index (LVMI), the early mitral valvular blood flow velocity peak/left ventricular sidewall mitral annulus late peak velocity, left ventricular sidewall mitral annulus early peak velocity/left ventricular sidewall mitral annulus late peak velocity, isovolumic relaxation time, peak twisting, peak untwisting velocity (PUV), untwisting rate (UntwR), time peak twisting velocity (TPTV), and time peak untwisting velocity (TPUV) between the DM A, DM B, and control groups. While the peak twisting velocity (PTV) was slower in the DM B group compared with the control group, the RWT, PTV, PUV, UntwR, TPTV, and TPUV in the DM B group were significantly different from the DM A group.Conclusion: The cardiac function of patients with T2DM in its early stages, when there are no microvascular complications, could be monitored with the analysis of two-dimensional strain and torsion.
Highlights
As diabetes mellitus (DM) develops there is an evident increase in cardiovascular mortality (Rossi and American Diabetes Association, 2018)
This study aims to quantify the LV myocardial strain and torsion of patients with type 2 diabetes mellitus (T2DM) and evaluate the systolic and diastolic function by using conventional and speckle tracking echocardiography to determine the changes in the heart function of patients in the early stages of T2DM without microvascular complications
This study found that the 2D myocardial strain parameters, the global longitudinal strain (GLS), as well as the twisting parameters of the DM B group, were reduced when compared with the DM A group and the normal control group
Summary
As diabetes mellitus (DM) develops there is an evident increase in cardiovascular mortality (Rossi and American Diabetes Association, 2018). Two-dimensional speckle tracking echocardiography (2D-STE) is a novel method for the angle-independent quantification of LV strain, strain rate, and twist, with good reproducibility (Notomi et al, 2005; Qu et al, 2007; Blessberger and Binder, 2010; Mor-Avi et al, 2011; Huang et al, 2018), and STE can quantitatively analyze cardiac diastolic and systolic function (Santos-Gallego et al, 2020). This study aims to quantify the LV myocardial strain and torsion of patients with type 2 diabetes mellitus (T2DM) and evaluate the systolic and diastolic function by using conventional and speckle tracking echocardiography to determine the changes in the heart function of patients in the early stages of T2DM without microvascular complications
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