Assessment of left ventricular function in young type 1 diabetes mellitus patients by two-dimensional speckle tracking echocardiography: Relation to duration and control of diabetes

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• 作者：Sameh W.G. Bakhoum^a ; ^{samehbakhoum@live.com} ; Heba A. Habeeb^b ; ^{dr_heba_habib@yahoo.com} ; Ibrahim N. Elebrashy^c ; ^{iebrashy@gmail.com} ; Mary N. Rizk^c ; ^{Mnrizk1970@gmail.com}
• 关键词：A/C ratio ; albumin/creatinine ratio ; EF ; ejection fraction ; GLS ; global longitudinal strain ; GLSR ; global longitudinal strain rate ; GSRa ; diastolic global strain rate during late diastole ; GSRe ; diastolic global strain rate during early diastole ; GSRivr ; diastolic global strain rate during the isovolumic relaxation period ; HbA1c ; glycosylated hemoglobin ; HDL-C ; high density lipoprotein cholesterol ; LDL-C ; low density lipoprotein cholesterol ; LV ; left ventricular ; LVEDD ; left ventricular end dias
• 刊名：The Egyptian Heart Journal
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：68
• 期：4
• 页码：217-225
• 全文大小：1881 K
• 卷排序：68

文摘

The effect of type 1 diabetes mellitus (T1DM) on myocardial function is still controversial.AimTo examine the usefulness of speckle tracking echocardiography (STE) in detecting subclinical left ventricular (LV) dysfunction in asymptomatic T1DM patients and detect whether any LV abnormalities are related to duration or control of DM.MethodsSixty young T1DM patients and 30 controls were subjected to conventional echocardiography and STE. The left ventricular (LV) peak systolic (PS) global longitudinal strain (GLS)/strain rate (GLSR) and diastolic global strain rate during the isovolumic relaxation period (GSRivr), early diastole (GSRe) and late diastole (GSRa) were calculated as the average of the 12 myocardial segments of the four and two-chamber views while the mid circumferential strain (MCS) was calculated as the average of strains of the 6 LV segments of the mid LV cavity.ResultsIn diabetic patients, the LV end diastolic dimension (LVEDD) was significantly lower (p = 0.000) while the LV myocardial performance index (LVMPI) and E/lateral E′ ratio were significantly higher (p = 0.000 and p = 0.02 respectively) compared to controls. By STE, only the GLS was significantly lower in diabetic patients compared to controls (p = 0.000). A significant negative correlation was detected between LDL-C and GLS (r = −0.4; p = 0.002). Multivariate logistic regression analysis identified HbA1c as the only independent predictor of GLS in patients (beta = −0.34, 95% CI: −0.67 to −0.19; p = 0.001).ConclusionSTE is useful to detect subclinical LV dysfunction in asymptomatic patients with T1DM. Control of DM but not duration of disease was an independent predictor of LV systolic dysfunction.