GW25-e1590 Evaluation of left ventricular myocardial function in coronary atherosclerosis patients with Type 2 Diabetes Mellitus by Speckle Tracking Echocardiography

Abstract Background Left ventricular (LV) longitudinal myocardial dysfunction is considered a marker of preclinical LV dysfunction in patients with type 2 diabetes mellitus (T2DM). High heart rate (HR) is associated with cardiovascular outcomes, but the effect of HR on LV longitudinal myocardial function in T2DM patients is uncertain. Methods We studied 192 T2DM patients with preserved LV ejection fraction (LVEF), and 81 age-, sex-, and LVEF-matched healthy volunteers. HR was measured as the average HR during echocardiography, and high HR was defined as resting HR ≥ 70 beats/minute. LV longitudinal myocardial function was assessed as global longitudinal strain (GLS). The predefined cutoff for subclinical LV dysfunction was set at GLS < 18%. Results GLS in T2DM patients with high HR was significantly lower than that in T2DM patients with low HR (16.3% ± 4.2% vs. 17.8% ± 2.8%; P = 0.03), whereas GLS in normal subjects with high and low HR was similar (20.3 ± 1.7% vs. 20.3 ± 2.0%; P = 0.99). Multivariable logistic regression analysis showed that high HR (odds ratio: 1.04; 95% confidence interval: 1.01–1.07; P = 0.01) was independently associated with GLS < 18% in T2DM patients as well as HbA1c, T2DM duration, LVEF, body mass index, and mitral inflow E and mitral e’ annular velocity ratio. One sequential logistic model evaluating the associations between GLS < 18% and clinical variables in T2DM patients showed an improvement with the addition of LVEF and E/e’ (P < 0.001) and a further improvement with the addition of high HR (P < 0.001). Conclusion Compared with normal subjects, resting HR was associated with LV longitudinal myocardial function in asymptomatic T2DM patients with preserved LVEF. Our findings provide new insights on the management of T2DM patients.

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Improvement of continuous subcutaneous insulin infusion on patients with type 2 diabetes mellitus by 3-dimensional speckle tracking echocardiography

The International Journal of Cardiovascular Imaging ◽

10.1007/s10554-017-1245-5 ◽

2017 ◽

Vol 34 (3) ◽

pp. 379-384 ◽

Cited By ~ 1

Author(s):

Hong-xia Luo ◽

Xiao-ling Zhou ◽

Hong-ju Kou ◽

Xian-wei Ni ◽

Qing Wu ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Continuous Subcutaneous Insulin Infusion ◽

Speckle Tracking ◽

Insulin Infusion ◽

Speckle Tracking Echocardiography ◽

Subcutaneous Insulin ◽

3 Dimensional

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Short-term flexibility of myocardial triglycerides and diastolic function in patients with type 2 diabetes mellitus

AJP Endocrinology and Metabolism ◽

10.1152/ajpendo.90413.2008 ◽

2008 ◽

Vol 295 (3) ◽

pp. E714-E718 ◽

Cited By ~ 50

Author(s):

Sebastiaan Hammer ◽

Rutger W. van der Meer ◽

Hildo J. Lamb ◽

Hans H. de Boer ◽

Jeroen J. Bax ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Diastolic Function ◽

Myocardial Function ◽

Left Ventricular ◽

Plasma Nefa ◽

Short Term ◽

Nonesterified Fatty Acids

Short-term caloric restriction increases plasma levels of nonesterified fatty acids (NEFAs) and is associated with increased myocardial triglyceride (TG) content and decreased myocardial function in healthy subjects. Whether this flexibility of myocardial TG stores and myocardial function is also present in patients with type 2 diabetes mellitus (T2DM) is yet unknown. Myocardial TG content and left ventricular (LV) ratio between the early (E) and atrial (A) diastolic filling phase (E/A) were determined using magnetic resonance (MR) spectroscopy and MR imaging, respectively, before and after a 3-day very low-calorie diet (VLCD) in 11 patients with T2DM. In addition, we studied patients after a 3-day VLCD combined with the antilipolytic drug acipimox. The VLCD induced myocardial TG accumulation [from 0.66 ± 0.09% (mean ± SE, baseline) to 0.98 ± 0.16%, P = 0.028] and a decrease in E/A ratio [from 1.00 ± 0.05 (baseline) to 0.90 ± 0.06, P = 0.002]. This was associated with increased plasma NEFA levels (from 0.57 ± 0.08 mmol/l at baseline to 0.92 ± 0.12, P = 0.019). After the VLCD with acipimox, myocardial TG content, diastolic function, and plasma NEFA levels were similar to baseline values. In conclusion, in patients with T2DM, a VLCD increases myocardial TG content and is associated with a decrease in LV diastolic function. These effects were not observed when a VLCD was combined with acipimox, illustrating the physiological flexibility of myocardial TG stores and myocardial function in patients with T2DM.

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