scholarly journals P1394 Left atrial strain as a tool to explore disturbed system biology involving cerebral cognition in diabetes: A sub study of the European multicenter MOPEAD project

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
S K Saha ◽  
A Kiotsekoglou ◽  
A Borysenko ◽  
A Gopal ◽  
S C Govind
Keyword(s):  
Type 2 Diabetes ◽  
Strain Rate ◽  
Left Atrial ◽  
System Biology ◽  
Left Ventricular ◽  
Lv Function ◽  
Right Ventricular Free Wall ◽  
Lv Dysfunction ◽  
Strain And Strain Rate

Abstract Funding Acknowledgements EU GRANT OnBehalf MOPEAD STUDY GROUP Background Although the 2D speckle tracking software (2DSTE-SW) has been irrevocably proved to be useful for quantification of left ventricular (LV) function, the same SW has also been used successfully in a plethora of cardiac illnesses using left atrial (LA) strain and strain rate, even in the absence of a dedicated LA SW. LA peak longitudinal strain during ventricular systole (LA-Reservoir strain%; LA-Res S), and strain rate during early (LA-SRE) and late (LA-SRA) phases constitute respectively the reservoir (LA-RS%), conduit, and booster pump functions of this chamber. The role of this dynamic function has not been investigated to assess cerebral cognition in type 2 diabetes (DM). Methods We enrolled thirty-nine subjects with DM and mild LV dysfunction (76 ± 5 years, 25 F) in the EU- funded MOPEAD (Models of Patient Engagement for Alzheimer’s Disease) project. Fifteen of them underwent standard echocardiography and 2DSTE. We assessed cerebral cognition using the standard MMSE (Mini-Mental Stage Examination) score: we considered a score of less than 28 as a surrogate of mild cognitive impairment (MCI+). Besides LA-Res strain, LA-SRE, LA-SRA, LV-GLS and right ventricular free wall strain (RV-FWS) were also computed (RV-FWS). Routine biochemistry included, among other, HbA1c and NT-proBNP. Results Mean values of the 2D STE measures were LVGLS: 14± 3%, LAVI: 36± 21 ml/m2, LA -RS: 18 ±8 %, LA-SRE: 0.6± 0.3, and LA-SRA: 1.6± 0.4. RV FWS was 20± 5 %. HbA1c was 58 ± 16 mmol/mol. LVEF was 53± 7%. There was no difference in theses variable between MCI+ and those with normal cognition (MCI-). However, in the regression model, LA-Res S had the strongest association with MCI (P < 0.01) (Fig), with excellent strength of association ( R2 = 0.8). LA-SRE, indexed LA volume, and NT-proBNP were not retained by the model (p > 0.05). Conclusion LA reservoir strain may emerge as a useful tool to explore disturbed system biology involving extracardiac organ such as the brain in older adults with type 2 diabetes, in the background of mild LV dysfunction. Abstract P1394 Figure. Fig.Regression analysis

scholarly journals Aggravation of functional mitral regurgitation on left ventricle stiffness in type 2 diabetes mellitus patients evaluated by CMR tissue tracking

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Yi Zhang ◽  
Wei-feng Yan ◽  
Li Jiang ◽  
Meng-ting Shen ◽  
Yuan Li ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Mitral Regurgitation ◽  
Strain Rate ◽  
Left Ventricular ◽  
Functional Mitral Regurgitation ◽  
Lv Function ◽  
Peak Strain

Abstract Background Functional mitral regurgitation (FMR) is one of the most common heart valve diseases in diabetes and may increase left ventricular (LV) preload and aggravate myocardial stiffness. This study aimed to investigate the aggravation of FMR on the deterioration of LV strain in type 2 diabetes mellitus (T2DM) patients and explore the independent indicators of LV peak strain (PS). Materials and methods In total, 157 T2DM patients (59 patients with and 98 without FMR) and 52 age- and sex-matched healthy control volunteers were included and underwent cardiac magnetic resonance examination. T2DM with FMR patients were divided into T2DM patients with mild (n = 21), moderate (n = 19) and severe (n = 19) regurgitation. LV function and global strain parameters were compared among groups. Multivariate analysis was used to identify the independent indicators of LV PS. Results The T2DM with FMR had lower LV strain parameters in radial, circumferential and longitudinal direction than both the normal and the T2DM without FMR (all P < 0.05). The mild had mainly decreased peak diastolic strain rate (PDSR) compared to the normal. The moderate had decreased peak systolic strain rate (PSSR) compared to the normal and PDSR compared to the mild and the normal. The severe FMR group had decreased PDSR and PSSR compared to the mild and the normal (all P < 0.05). Multiple linear regression showed that the regurgitation degree was independent associated with radial (β = − 0.272), circumferential (β = − 0.412) and longitudinal (β = − 0.347) PS; the months with diabetes was independently associated with radial (β = − 0.299) and longitudinal (β = − 0.347) PS in T2DM with FMR. Conclusion FMR may aggravate the deterioration of LV stiffness in T2DM patients, resulting in decline of LV strain and function. The regurgitation degree and months with diabetes were independently correlated with LV global PS in T2DM with FMR.

Dapagliflozin improves left ventricular myocardial longitudinal function in people with type 2 diabetes

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A.J.M Brown ◽  
S Gandy ◽  
R McCrimmon ◽  
A Struthers ◽  
C Lang
Keyword(s):  
Type 2 Diabetes ◽  
Diastolic Function ◽  
Left Atrial ◽  
Left Ventricular ◽  
Funding Source ◽  
Longitudinal Function ◽  
Lv Dysfunction ◽  
Lv Diastolic Function ◽  
Atrial Area

Abstract Background/Introduction Asymptomatic left ventricular (LV) dysfunction is highly prevalent in patients with type 2 diabetes mellitus (T2DM). Sodium-glucose cotransporter 2 (SGLT2) inhibitors have been shown to reduce all-cause mortality and hospitalisations for heart failure in patients with T2DM. The underlying mechanisms for these cardiovascular benefits are unclear. In the Dapa-LVH trial, we had previously shown that dapagliflozin treatment significantly reduces LV mass (LVM) compared to placebo in patients with T2DM and LV hypertrophy (LVH). Purpose The objective of this sub-study of the Dapa-LVH study was to assess whether dapagliflozin treatment improves LV myocardial longitudinal function and LV diastolic function in patients with T2DM and LVH. Methods We randomly assigned 66 people (mean age 67±7 years, 38 males) with T2D, LVH with a normal LV ejection fraction to receive dapagliflozin 10mg once-daily or placebo for 12 months. The primary endpoints were change in global longitudinal strain (GLS) and LV diastolic function defined as the ratio of mitral inflow E to mitral e' annual velocities assessed using echocardiography. Secondary endpoints were left ventricular and atrial volumes assessed using cardiac magnetic resonance. Results Dapagliflozin treatment resulted in a median increase in GLS of −1.64±2.5% vs placebo −0.2±1.8; p=0.024, with a mean difference of −1.4% (95% CI: −2.7 to −0.2). There was a trend towards a reduction left atrial area with a median change in left atrial area of the dapagliflozin group −0.5±3.75 cm2 vs placebo group 0.0±3.5 cm2; p=0.088), leading to an absolute mean difference of −1.29cm2 (95% CI: −3.01 to 0.44). There was no significant difference between dapagliflozin and placebo in E/e' and in LV volumes. Conclusion Dapagliflozin treatment improved LV myocardial longitudinal function which may suggests it may improve subclinical LV dysfunction. Funding Acknowledgement Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): This study was funded by an Externally Sponsored Research grant from Astra Zeneca – (grant number ESR-14-10168

Findings from Left Ventricular Strain and Strain Rate Imaging in Asymptomatic Patients With Type 2 Diabetes Mellitus

2009 ◽  
Vol 104 (10) ◽  
pp. 1398-1401 ◽  
Author(s):  
Arnold C.T. Ng ◽  
Victoria Delgado ◽  
Matteo Bertini ◽  
Rutger W. van der Meer ◽  
Luuk J. Rijzewijk ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Strain Rate ◽  
Left Ventricular ◽  
Left Ventricular Strain ◽  
Strain Rate Imaging ◽  
Strain And Strain Rate ◽  
Asymptomatic Patients

scholarly journals The effects of doxorubicin on left and right atrial mechanics in patients with lymphoma

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Vahabi ◽  
E Kharati-Koopaei ◽  
M Stewart ◽  
H Hancock ◽  
M Norouzi ◽  
...  
Keyword(s):  
Strain Rate ◽  
Left Atrial ◽  
Left Ventricular ◽  
Right Atrial ◽  
Lv Function ◽  
Compensatory Mechanism ◽  
Research Association ◽  
Anthracycline Cardiotoxicity ◽  
Diastolic Strain Rate ◽  
Significant Change

Abstract Background Despite the associated dose-dependent cardiotoxicity, anthracyclines continue to form the backbone of modern chemotherapy regimens. Speckle Tracking Echocardiography (STE) has been a popular method of quantifying cardiac function but most studies have focused on left ventricular function. Research into the effects of anthracyclines on left atrial (LA) and right atrial (RA) function continues to be neglected. Purpose To investigate the effects of doxorubicin, a commonly used anthracycline, on both the LA and RA systolic and diastolic strain and strain-rate parameters in two groups of patients with lymphoma: Group 1 (G1) with a conventional drop in ejection fraction (EF &lt;53%), and Group 2 (G2) without. Methods We retrospectively studied 46 patients treated for lymphoma between 2015 and 2018; G1 (n=12) and G2 (n=34). Echocardiograms performed at baseline (T0), mid-chemotherapy (T1), and post-chemotherapy (T2), were analysed by using offline vendor-independent software (TomTec, 2D Cardiac Performance Analysis). Using 2D STE, LA and RA reservoir, conduit and contractile strains, systolic and diastolic strain-rates were measured. Multi-level longitudinal model was used for statistical analysis.This study was ethically approved by the Health Research Association (REC Reference 18/SS/0139). Results Median age was 64 years (IQR 51–74 years) in G1, and 65 years (IQR 57–73 years) in G2. In G1, there was no significant change in LA reservoir strain with time, however a significant decline with an average mean difference of −7.52 was seen between T0 to T2 (p=0.016) in G2. LA conduit strain did not significantly change in either group with incremental doses of doxorubicin. However, LA contraction strain was seen to significantly increase in G1 between T1 to T2 (p=0.045) with an average change of 7.23. LA peak systolic strain rate, and late diastolic strain rate did not show any significant change with time in both groups. Yet, a significant increase was seen in LA early diastolic strain rate between T0 to T2 (p=0.017) in G1 but not G2. No significant changes were seen in the RA strain parameters in both groups. Conclusion In patient with a reduction in LV function, a significant change was noted in the left atrial contraction strain and early diastolic strain rate with incremental doses of doxorubicin. These changes shows the close relationship between the LA and LV, and the importance of LA in providing a compensatory mechanism for a decline in LV function secondary to anthracycline cardiotoxicity. Funding Acknowledgement Type of funding source: None

scholarly journals Effect of heart rate on left ventricular longitudinal myocardial function in type 2 diabetes mellitus

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Yuki Yamauchi ◽  
Hidekazu Tanaka ◽  
Shun Yokota ◽  
Yasuhide Mochizuki ◽  
Yuko Yoshigai ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Heart Rate ◽  
Type 2 Diabetes Mellitus ◽  
Myocardial Function ◽  
Normal Subjects ◽  
Left Ventricular ◽  
High Heart Rate ◽  
Lv Dysfunction

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.

Left Ventricular Geometry and Function in Normotensive and Hypertensive Patients with Type 2 Diabetes Mellitus without Overt Cardiac Symptoms

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
GA Amusa ◽  
SU Uguru ◽  
BI Awokola
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Left Ventricular ◽  
Left Ventricular Geometry ◽  
Hypertensive Patients ◽  
Lv Dysfunction ◽  
Cardiac Symptoms ◽  
And Function

Cardiovascular disease (CVD) is a common cause of morbidity/mortality in patients with type 2 diabetes mellitus (T2DM). Echocardiography can detect changes in cardiac geometry/function before overt CVD symptoms. This study aimed to evaluate left ventricular (LV) geometry and function in normotensive/hypertensive patients with T2DM without overt cardiac symptoms. A cross-sectional study in which fifty normotensives and fifty hypertensive adults with DM without overt cardiac symptoms were enrolled from the cardiology/diabetes clinics of Jos University Teaching Hospital (JUTH) in a simple random manner. Relevant history, physical examination and biochemical investigations were performed. 12-lead electrocardiography and echocardiograph assessment of LV geometry and function were also performed. Data was analyzed using Epi-info 7 statistical software; p value < 0.05 was considered significant. There were 27 females and 29 females in both groups. The prevalence of abnormal LV geometry was 36.0%, 95% CI 33.2-38.8% and 58.0%, 95% CI 55.2-60.8% in the normotensive and hypertensive groups respectively, P=0.028. Similarly, the prevalence of LV dysfunction was 38.0%, 95%CI 35.2-40.8% and 62.0%, 95%CI 59.2-64.8% respectively, P=0.017. The independent predictors of LV dysfunction were found to be duration of diabetes (OR 7.74, 95%CI 4.46-10.46), duration of hypertension ≥5years (OR 4.15, 95%CI 4.01-9.27), smoking (OR 4.34, 95%CI 1.32-6.23), body mass index ≥25 (OR 5.53, 95%CI 1.38-2.09) and glycosylated haemoglobin ≥7 (OR 7.11, 95%CI 2.15-0.81).  There is high prevalence of LV dysfunction/abnormal LV geometry in T2DM patients without overt cardiac symptoms; co-morbid hypertension worsens these abnormalities. Early and periodic echocardiography is recommended with appropriate intervention in these patients.

scholarly journals Do left atrial strain and strain rate reflect intrinsic atrial function, or are they determined by left ventricular function?

2015 ◽  
pp. 539-548 ◽  
Author(s):  
Andrei Dumitru Margulescu ◽  
Emma Rees ◽  
Rose-Marie Coulson ◽  
Aled D. Rees ◽  
Dragos Vinereanu ◽  
...  
Keyword(s):  
Left Ventricular Function ◽  
Strain Rate ◽  
Ventricular Function ◽  
Left Atrial ◽  
Left Ventricular ◽  
Atrial Function ◽  
Left Atrial Strain ◽  
Strain And Strain Rate ◽  
Atrial Strain

scholarly journals Impact of Myocardial Scars on Left Ventricular Deformation in Type 2 Diabetes Mellitus After Myocardial Infarction by Contrast-Enhanced Cardiac Magnetic Resonance

2021 ◽  
Author(s):  
Yue Gao ◽  
Hua-yan Xu ◽  
Ying-kun Guo ◽  
Xiao-ling Wen ◽  
Rui Shi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cardiac Magnetic Resonance ◽  
Anterior Wall ◽  
Left Ventricular ◽  
Lv Function ◽  
Myocardial Scars

Abstract Background Type 2 diabetes mellitus (T2DM) is a major risk factor for coronary artery disease and myocardial infarction (MI). The interaction of diabetic cardiomyopathy and MI scars on myocardial deformation in T2DM patients is unclear. Therefore, we aimed to evaluated myocardial deformation using cardiac magnetic resonance (CMR) in T2DM patients with previous MI and investigated the influence of MI on left ventricular (LV) deformationMethods Two hundred and two T2DM patients, including 46 with MI (T2DM(MI+)) and 156 without MI (T2DM(MI−)), and 59 normal controls who underwent CMR scans were included. Myocardial scars were assessed by late gadolinium enhancement. LV function and deformation, including LV global function index, LV global peak strain (PS), peak systolic strain rate (PSSR), and peak diastolic strain rate (PSDR), were compared among these groups. Correlation analysis and multivariate linear regression analyses were used to investigate the relationship between myocardial scars and LV deformation.Results There was a decrease in LV function and LV global PS, PSSR, and PDSR in the T2DM(MI+) group compared with those of the other groups. Furthermore, reduced LV deformation (p < 0.017) was observed in the T2DM(MI+) group with anterior wall infarction. The increased total LV infarct extent and infarct mass of LV were related to decreased LV global PS (radial, circumferential, and longitudinal directions; p < 0.01) and LV global PSSR (radial and circumferential directions, p < 0.02). Multivariate analysis demonstrated that NYHA functional class and total LV infarct extent were independently associated with LV global radial PS (β = −0.400 and β = −0.446, respectively, all p < 0.01; model R2 = 0.37) and circumferential PS (β = −0.339 and β = −0.530, respectively, all p < 0.01; model R2 = 0.41), while LV anterior wall infarction was independently associated with LV global longitudinal PS (β = −0.398, p = 0.006).Conclusions The myocardial scarring size in T2DM patients after MI is negatively correlated with LV global PS and PSSR, especially in the circumferential direction. Additionally, different MI regions have different effects on the reduction of LV deformation, and relevant clinical evaluations should be strengthened.

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