scholarly journals Incremental Value of Global Longitudinal Strain in Predicting Heart Failure in Patients with Type 2 Diabetes Mellitus

2017 ◽  
Vol 26 ◽  
pp. S137
Author(s):  
Y. Wang ◽  
H. Yang ◽  
M. Nolan ◽  
K. Negishi ◽  
T. Marwick
2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
K Uneno

Abstract Background Type 2 diabetes mellitus (T2DM) impairs cardiac function and is one of the risk factors for heart failure. However, the mechanism of cardiac impairment is not elucidated. Despa et al. reported that amylin has aggregation properties similar to amyloidogenic proteins and impairs cardiac function in T2DM patients with hyperamylinemia. In this hypothesis, T2DM-induced myocardial impairment is thought of as amylin-induced cardiac amyloidosis. The purpose of this study is to clarify whether a relative apical sparing pattern (RASP), which is well known as a typical pattern of cardiac amyloidosis, is common in T2DM. Methods We studied patients aged 75 years or over who underwent echocardiography from January 2018 to December 2020 in our clinic. We calculated the quantitative relative apical sparing (qRASP) as average apical-longitudinal strain (LS)/(average basal-LS + average mid-LS) in each patient. According to the validated threshold, a qRASP ≥1.0 was defined as an obvious RASP (oRASP). We compared the ratio of oRASP between patients with and without T2DM. Results We researched 506 patients, mean 81.8 years, 290 females, 133 with T2DM. The average age, atrial fibrillation rate, heart failure rate, and hypertension rate were similar in both groups. The ratio of ischemic heart disease was higher in the T2DM group. Echocardiography showed that the left atrial dimension (LAD), E/e', and left ventricular hypertrophy (LVH) ratio was higher in the T2DM group. Speckle tracking echocardiography revealed that global longitudinal strain (GLS) and qRASP of the T2DM group were higher than the non-DM group (GLS;-18.0% vs. −19.2%, p<0.001. qRASP; 0.809 vs. 0.699, P<0.001). Furthermore, the ratio of oRASP was significantly higher in the T2DM group (19.0% vs. 1.34%, p<0.001). Multivariable logistic regression analysis showed T2DM was an independent predictor for oRASP. Conclusion This study revealed that the qRASP and the ratio of oRASP in the T2DM group were higher than non-DM group. This finding supports the hypothesis that T2DM related cardiomyopathy is a kind of cardiac amyloidosis caused by amylin. FUNDunding Acknowledgement Type of funding sources: None.


2020 ◽  
Author(s):  
Sameh Samir Raafat ◽  
Nour Eldin M. Nazmy ◽  
Islam M. Bastawy ◽  
Yasser A. Abdellatif

Abstract Background: Type 2 diabetes mellitus (T2DM) insidiously affects the myocardium with subsequent cardiomyopathy, it also pathologically involves the microvascular bed of the kidney reflected by albuminuria. This study aimed to investigate the relation between albuminuria and subclinical left ventricular (LV) systolic dysfunction in asymptomatic normotensive patients with T2DM assessed by two-dimensional (2D) speckle tracking echocardiography.Methods and results Sixty normotensive patients with T2DM, within 5 years of initial diagnosis, receiving conventional oral antidiabetic medications were included and subdivided into 2 subgroups, each including thirty patients according to the presence of albuminuria, together with thirty healthy control subjects all underwent full echocardiographic examination including left ventricular (LV) regional and global longitudinal strain (GLS) measurements. Laboratory tests including serum creatinine, glycated hemoglobin (HbA1C) and albumin creatinine ratio (ACR) were withdrawn for the three groups. There was a significant reduction in average peak systolic LV global longitudinal strain (GLS) in patients with T2DM when compared to control group (-16.18 ± 2.78% versus -18.13 ± 2.86%, P<0.001), however there was no significant difference in average peak systolic LV GLS between both diabetic subgroups (-15.57 ± 2.77% in subgroup with albuminuria versus -16.79 ± 2.70% in subgroup without albuminuria, p=0.077). Moreover, there was a significant correlation between ACR and reduction of GLS in patients with T2DM and albuminuria (r =0.38, P=0.003). However, this correlation was absent in patients with T2DM without albuminuria (r=0.107, P=0.573). Conclusion: Patients with type 2 diabetes mellitus (T2DM) have subclinical LV systolic dysfunction despite normal ejection fraction through reduction of average peak systolic LV GLS that is correlated with albumin creatinine ratio in patients with T2DM and albuminuria.


2016 ◽  
Vol 22 ◽  
pp. 20-21
Author(s):  
Aditya D. Raju ◽  
Anna D. Coutinho ◽  
Weijia Wang ◽  
Sharash Shetty ◽  
Stephen S. Sander ◽  
...  

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1142-P
Author(s):  
DOMINIC PILON ◽  
MICHAEL DURKIN ◽  
AMEUR MANCEUR ◽  
ISABELLE GHELERTER ◽  
MARIE-HÉL LAFEUILLE ◽  
...  

2019 ◽  
Vol 19 (20) ◽  
pp. 1818-1849 ◽  
Author(s):  
Ban Liu ◽  
Yuliang Wang ◽  
Yangyang Zhang ◽  
Biao Yan

: Type 2 diabetes mellitus is one of the most common forms of the disease worldwide. Hyperglycemia and insulin resistance play key roles in type 2 diabetes mellitus. Renal glucose reabsorption is an essential feature in glycaemic control. Kidneys filter 160 g of glucose daily in healthy subjects under euglycaemic conditions. The expanding epidemic of diabetes leads to a prevalence of diabetes-related cardiovascular disorders, in particular, heart failure and renal dysfunction. Cellular glucose uptake is a fundamental process for homeostasis, growth, and metabolism. In humans, three families of glucose transporters have been identified, including the glucose facilitators GLUTs, the sodium-glucose cotransporter SGLTs, and the recently identified SWEETs. Structures of the major isoforms of all three families were studied. Sodium-glucose cotransporter (SGLT2) provides most of the capacity for renal glucose reabsorption in the early proximal tubule. A number of cardiovascular outcome trials in patients with type 2 diabetes have been studied with SGLT2 inhibitors reducing cardiovascular morbidity and mortality. : The current review article summarises these aspects and discusses possible mechanisms with SGLT2 inhibitors in protecting heart failure and renal dysfunction in diabetic patients. Through glucosuria, SGLT2 inhibitors reduce body weight and body fat, and shift substrate utilisation from carbohydrates to lipids and, possibly, ketone bodies. These pleiotropic effects of SGLT2 inhibitors are likely to have contributed to the results of the EMPA-REG OUTCOME trial in which the SGLT2 inhibitor, empagliflozin, slowed down the progression of chronic kidney disease and reduced major adverse cardiovascular events in high-risk individuals with type 2 diabetes. This review discusses the role of SGLT2 in the physiology and pathophysiology of renal glucose reabsorption and outlines the unexpected logic of inhibiting SGLT2 in the diabetic kidney.


2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
AA Garganeeva ◽  
EA Kuzheleva ◽  
VA Fedyunina ◽  
VA Aleksandrenko

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): This study was funded by (subject of fundamental scientific research on a state assignment № АААА-А17-117052310073-6 от 23.05.2017 Introduction. Growth differentiation factor-15 (GDF-15) is a biomarker associated with inflammatory processes in the pathogenesis of chronic heart failure (CHF) which expresses in cardiomyocytes under pathological conditions. The relationship between the level of GDF-15 and type 2 diabetes mellitus (T2DM) has also been proven. It is necessary to study GDF-15 in patients with CHF and T2DM. Aim To investigate the association between serum GDF-15 levels in patients with CHF of ischemic etiology and the concentration of the main leukocyte fractions depending on presence or absence of T2DM. Material and methods. The study included 42 patients. The patients were divided into 2 groups. The first group consisted of patients with CHF and T2DM (n = 14). The second group  consisted of patients with CHF without T2DM (n = 28). Determination of GDF-15 concentration was carried out by enzyme-linked immunosorbent assay (BioVendor, Czech Republic). The absolute concentration of lymphocytes, neutrophils, as well as the ratio of neutrophils to lymphocytes in the blood were analyzed. Statistical analysis was performed using the Statistica software (v.10.0). The data were described as a median and interquartile range, the Mann-Whitney test was used to compare them. The correlation analysis was tested using the Spearman"s correlation coefficient. Results and discussion. The average level of the GDF-15 in the study groups was comparable: 2389 (2104; 3375) pg/ml and 2309 (2047; 3014) pg/ml in the first and second groups, respectively (p = 0.6). In the general cohort of CHF patients, the GDF-15 concentration was not correlate with the lymphocytes concentration (r = -0.001, p = 0.95), neutrophils (r = -0.14, p = 0.4) and the ratio of neutrophils to lymphocytes (r = -0.12, p = 0.25). At the same time, in the group of patients with T2DM, a significant negative correlation was revealed between the concentration of GDF-15 in the serum and the concentration of neutrophils (r = -0.6, p = 0.022). While both other analyzed parameters did not demonstrate significant correlations with GDF-15 (p &gt; 0.05). In the group of CHF patients without T2DM, no correlations were found between GDF-15 and the studied parameters, including neutrophils (r = 0.02, p = 0.3). Along with this the median of the neutrophils concentration did not vary among groups (3.5 (2.3; 5.3) vs 3.2 (2.7; 4.1) * 109 / l; p = 0.8). Conclusion The concentration of the inflammatory marker GDF-15 in the blood of patients with CHF in combination with T2DM correlates with the concentration of neutrophils. In the absence of T2DM, no significant correlations were found between GDF-15 and the main leukocyte fractions. The results obtained indicate the possible prospect of using the GDF-15 biomarker in a cohort of patients with CHF in combination with T2DM.


2021 ◽  
Vol 32 ◽  
pp. 100739
Author(s):  
Claire A Lawson ◽  
Samuel Seidu ◽  
Francesco Zaccardi ◽  
Gerry McCann ◽  
Umesh T Kadam ◽  
...  

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