Abstract 2487: Torsional and Reverse Rotational Mechanics of the Left Ventricular Apex Is Abnormal in Patients with Type 2 Diabetes Mellitus Independent of Presence of Hypertension, Left Ventricular Hypertrophy, Elevated Filling Pressures and Left Atrial Volume

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Wei Zhao ◽  
Peng Li ◽  
Geu-Ru Hong ◽  
Shizhen Liu ◽  
Helene Houle ◽  
...  
Keyword(s):  
Ventricular Hypertrophy ◽  
Left Atrial Volume ◽  
Rotation Velocity ◽  
Left Ventricular ◽  
List Type ◽  
Type 2 Dm ◽  
Apical Rotation ◽  
Rotational Mechanics ◽  
Normal Lvef

Background : Diastolic dysfunction (DD) is common in patients with Type 2 DM even in the absence of HTN and LVH. We tested whether apical rotational mechanics offered any additional insights into DD in DM over conventional echo-Doppler measures. Methods: We studied 4 groups : 12 normals (wall thickness-WT 0.9±0.1cm); 17 patients with DM (WT 1.0±0.1cm, HbA1c 7±1%, BP 128±4/68±5 mmHg); 16 patients with DM +HTN (WT 0.9±0.1cm, HbA1c 7±1%, BP 134±23/72±18 mmHg); and 20 patients with DM+HTN+LVH (WT 1.4±0.2cm, HbA1c 7±4%, BP 135±13/76±9mmHg). All patients had normal LVEF and mitral E/A ratio. SAX of the LV apex and base were obtained. Velocity Vector Imaging (Siemens, CA) was used to measure: Longitudinal myocardial velocity (LMV, cm/sec) and strain (LS,%); Apical rotation velocity (ARV, cm/sec)and reverse rotation velocity(ARRV, cm/sec); Apical rotation (AR, degree) and LV torsion-LVTOR (degree/cm, and Circumferential (CS,%) and Radial strains (RS,%). Results: Figure shows LVTOR and % reduction in ARRV data. All other data will be presented. Thus, LV torsion is increased in DM alone or DM+HTN (-LVH) groups. But ARRV is reduced by ~ 20% in these groups even with relatively normal E/E’ ratio and LAVI. In the DM+HTN+LVH group, E/E’ and LAVI are increased and apical rotational mechanics resemble the same spectrum as the above groups but are more severe (~25% reduction in ARRV). Thus, reduction in ARRV is a marker of early DD in DM even in the absence of LVH . Conclusions: Apical rotational mechanics is more sensitive than conventional echo-Doppler measures to identify myocardial DD in type 2 DM even in the presence of normal E/A ratio, LAVI and LVEF, and in the absence of HTN and/or LVH.

scholarly journals Microalbuminuria as an early marker of left ventricular hypertrophy in type 2 diabetes mellitus

2017 ◽  
Vol 4 (3) ◽  
pp. 666
Author(s):  
Balshine S. Kanwar ◽  
Abhishek Gupta ◽  
Sunil K. Virmani
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
P Value ◽  
Type 2 Dm ◽  
Lv Mass

Background: Microalbuminuria and left ventricular hypertrophy (LVH) have both been shown independently to be associated with increased cardiovascular (CVS) mortality in type 2 diabetes mellitus (DM) patients. This cross-sectional study was conducted to examine whether microalbuminuria is associated with LVH in non-hypertensive type 2 DM patients with early or no diabetic nephropathy.Methods: 100 patients of type 2 DM were studied. Patients with Hypertension (BP >140/90 mm hg or on anti-hypertensive medication), history of coronary artery disease or valvular heart disease, estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2, known thyroid disease or active urinary tract infection (UTI) were excluded from the study. All patients were subjected to spot urine test for microalbuminuria by urinary albumin creatinine ratio (UACR), 12 lead ECG to detect LVH, 2D echocardiography to calculate LV mass index (LVMI), anthropometry, urine routine examination, kidney function test, fasting lipid profile and HbA1c.Results: Of the 100 enrolled patients, 39 were found to have normoalbuminuria, 39 had microalbuminuria & 22 patients had macroalbuminuria. The correlation between increased albuminuria and LVMI was found to be statistically significant (P value < 0.001) and the LV mass significantly increased as albuminuria increased along the continuum of normoalbuminuria to macroalbuminuria. UACR showed a statistically significant correlation with age, eGFR, duration of diabetes (P value < 0.01) and HbA1c (P value < 0.05).Conclusions: Microalbuminuria is associated with LVH in non-hypertensive type 2 DM patients and thus may serve as an early marker of LVH and help identify patients at high CVS risk.

scholarly journals Assessment of structural and functional myocardial characteristics in patients with chronic coronary artery disease and various glycemic status

2021 ◽  
Vol 20 (7) ◽  
pp. 3077
Author(s):  
M. A. Kokozheva ◽  
B. U. Mardanov ◽  
E. A. Poddubskaya ◽  
V. A. Kutsenko ◽  
M. A. Umetov ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Exercise Tolerance ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Control Group ◽  
Glycemic Status ◽  
Artery Disease

Aim. To study the structural and functional myocardial characteristics in patients with exertional angina and type 2 diabetes in comparison with those without diabetes to identify combined hemodynamic changes.Material and methods. Patients were divided into two groups depen - ding on the glycemic status. The first group consisted of 49 patients (mean age, 57,9±1,04 years; male/female, 35/14) with coronary artery disease (CAD) and type 2 diabetes, while the second one (control)  — 51 patients (60,2±0,9 years, 34/17) with CAD and without diabetes. Patients were surveyed using a standard questionnaire that included socio-demographic parameters, behavioral risk factors, clinical status, medications received, and comorbidities. Diagnostic investigations were carried out, including resting electrocardiography, transthoracic echocardiography and cycle ergometry.Results. Among patients with CAD and type 2 diabetes, hypertension occurred 20% more often compared with the control group  — 98 vs 78% (p<0,004). According to the electrocardiography, the combination of diabetes and CAD was characterized by various arrhythmias, which were recorded 2,8 times more often than in the group without diabetes. According to echocardiography, signs of left ventricular hypertrophy, systolic and diastolic dysfunction prevailed in people with diabetes. Mean pulmonary artery pressure in patients with diabetes were higher than in patients without carbohydrate metabolism disorders (p<0,004). According to the stress test, exercise tolerance in experimental group patients was lower than in patients in the control group.Conclusion. The combination of chronic CAD and type 2 diabetes is cha - racterized by a more common combination with hypertension, impaired central and intracardiac hemodynamics, as well as left ventricular hypertrophy. In people with diabetes, impaired systolic and diastolic myocardial function is combined with reduced exercise tolerance.

scholarly journals Maturational patterns of left ventricular rotational mechanics in pre-term infants through 1 year of age

2020 ◽  
Vol 30 (9) ◽  
pp. 1238-1246
Author(s):  
Gloria C. Lehmann ◽  
Philip T. Levy ◽  
Meghna D. Patel ◽  
Timothy Sekarski ◽  
HongJie Gu ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Neonatal Period ◽  
Ductus Arteriosus ◽  
Left Ventricular ◽  
Term Infants ◽  
Apical Rotation ◽  
Cardiopulmonary Complications ◽  
Rotational Mechanics ◽  
The Impact ◽  
Over Time

AbstractBackground:Pre-mature birth impacts left ventricular development, predisposing this population to long-term cardiovascular risk. The aims of this study were to investigate maturational changes in rotational properties from the neonatal period through 1 year of age and to discern the impact of cardiopulmonary complications of pre-maturity on these measures.Methods:Pre-term infants (<29 weeks at birth, n = 117) were prospectively enrolled and followed to 1-year corrected age. Left ventricular basal and apical rotation, twist, and torsion were measured by two-dimensional speckle-tracking echocardiography and analysed at 32 and 36 weeks post-menstrual age and 1-year corrected age. A mixed random effects model with repeated measures analysis was used to compare rotational mechanics over time. Torsion was compared in infants with and without complications of cardiopulmonary diseases of pre-maturity, specifically bronchopulmonary dysplasia, pulmonary hypertension, and patent ductus arteriosus.Results:Torsion decreased from 32 weeks post-menstrual age to 1-year corrected age in all pre-term infants (p < 0.001). The decline from 32 to 36 weeks post-menstrual age was more pronounced in infants with cardiopulmonary complications, but was similar to healthy pre-term infants from 36 weeks post-menstrual age to 1-year corrected age. The decline was due to directional and magnitude changes in apical rotation over time (p < 0.05).Conclusion:This study tracks maturational patterns of rotational mechanics in pre-term infants and reveals torsion declines from the neonatal period through 1 year. Cardiopulmonary diseases of pre-maturity may negatively impact rotational mechanics during the neonatal period, but the myocardium recovers by 1-year corrected age.

scholarly journals Cardiac Function in Uncomplicated Type 2 Diabetes Mellitus

2019 ◽  
Vol 18 (2) ◽  
pp. 211-215
Author(s):  
Bimal K Agrawal ◽  
Parul Jain ◽  
Saurabh Marwaha ◽  
Richa Goel ◽  
Himanshu D Kumar ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cardiac Function ◽  
Cardiac Dysfunction ◽  
Left Ventricular ◽  
Diabetic Patients ◽  
Coronary Arterial Disease ◽  
Type 2 Dm

Objective: Diabetic cardiomyopathy (DC) is a myocardial disease characterized by myocyte hypertrophy, interstitial fibrosis, protein glycosylation and intra-myocardial micro-angiopathy due to prolonged exposure of myocardial tissues to hyperglycemia in diabetes mellitus (DM) patients. Alteration in cardiac function can be non-invasively assessed via echocardiography. The early recognition of cardiac dysfunction can prevent the symptomatic heart failure in DM patients. The study aimed at evaluating cardiac function in uncomplicated type 2 diabetes mellitus. Materials And Methods: Sixty Type 2 DM patients without any feature of the coronary arterial disease (CAD), hypertension, nephropathy and respiratory illness were enrolled in the study and compared with the sixty age matched healthy controls. Echocardiographic assessment was done in all subjects to evaluate the cardiac function. Results: Diastolic dysfunction was more common in diabetic patients when compared with normal healthy population. Systolic dysfunction progresses with age of the diabetic patient. Conclusion: Echocardiography is a simple noninvasive cost effective test for detecting cardiac dysfunction in Type 2 DM patients and should be applied to detect early Left ventricular(LV) dysfunction so that corrective measures may be initiated early and cardiac functions may be preserved for long. Bangladesh Journal of Medical Science Vol.18(2) 2019 p.211-215

Impact of 1, 25-(OH)2D3 on Left Ventricular Hypertrophy in Type 2 Diabetic Rats

2015 ◽  
Vol 30 (2) ◽  
pp. 114-120 ◽  
Author(s):  
Ying Fan ◽  
Shan-xiao Zhang ◽  
Meng Ren ◽  
Li-feng Hong ◽  
Xiao-ni Yan
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Diabetic Rats ◽  
Left Ventricular ◽  
Type 2 Diabetic
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