scholarly journals Left ventricular subclinical myocardial dysfunction in uncomplicated type 2 diabetes mellitus is associated with impaired myocardial perfusion: a contrast-enhanced cardiovascular magnetic resonance study

2018 ◽  
Vol 17 (1) ◽  
Author(s):  
Xi Liu ◽  
Zhi-gang Yang ◽  
Yue Gao ◽  
Lin-jun Xie ◽  
Li Jiang ◽  
...  
2020 ◽  
Author(s):  
Ju-Hua Liu ◽  
Mei-Zhen Wu ◽  
Si-Min Li ◽  
Yan Chen ◽  
Qing-Wen Ren ◽  
...  

Abstract BackgroundIncreased serum uric acid (SUA) is common in patients with type 2 diabetes mellitus (T2DM) and is associated with left ventricular (LV) myocardial dysfunction. Nonetheless the association of SUA with right ventricular (RV) function in patients with T2DM has not been studied. This study aimed to investigate the association of SUA with biventricular myocardial function in patients with T2DM.MethodsA total of 560 patients with T2DM were enrolled and divided into four groups according to quartile of SUA. Transthoracic echocardiography was performed and two-dimensional speckle tracking used to measure biventricular myocardial strain, including LV global longitudinal strain (GLS), circumferential strain (CS), radial strain (RS), and RV free wall longitudinal stra in (RV-FWLS).Results The absolute value of all biventricular strain parameters showed a stepwise decrease across SUA quartiles (all P<0.01). In particular, LV assessment by GLS, CS and RS demonstrated that those in the 4th quartile were impaired compared with the other quartiles (all P<0.05). Similarly, RV-FWLS of the 4th quartile was significantly impaired compared with the 1st and 2nd quartiles (all P<0.05). The same reduction in biventricular strain across SUA quartiles was observed in patients with estimated glomerular filtration rate<or ≥60 ml/min/1.73 m2, and glycated hemoglobin < or ≥7.0% (all P<0.05). Multivariable linear regression analysis demonstrated that higher quartile of SUA was independently associated with impaired biventricular myocardial strain (all P<0.05). ConclusionsSUA was independently associated with biventricular myocardial dysfunction in asymptomatic T2DM patients, regardless of renal function or diabetic control.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Yuki Yamauchi ◽  
Hidekazu Tanaka ◽  
Shun Yokota ◽  
Yasuhide Mochizuki ◽  
Yuko Yoshigai ◽  
...  

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.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Yi Zhang ◽  
Wei-feng Yan ◽  
Li Jiang ◽  
Meng-ting Shen ◽  
Yuan Li ◽  
...  

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.


Author(s):  
GA Amusa ◽  
SU Uguru ◽  
BI Awokola

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.


2011 ◽  
Vol 29 (10) ◽  
pp. 1994-2003 ◽  
Author(s):  
Giovanni Cioffi ◽  
Pompilio Faggiano ◽  
Donata Lucci ◽  
Andrea Di Lenarda ◽  
Gian Francesco Mureddu ◽  
...  

Author(s):  
Swapnil Jain ◽  
C. L. Nawal ◽  
Amandeep Singh ◽  
Radhey Shyam Chejara ◽  
Sagar Barasara ◽  
...  

Background: Diastolic dysfunction in patients suffering from diabetes mellitus represents an earlier stage in the natural history of cardiomyopathy. This study was done to assess the left ventricular diastolic dysfunction in recently diagnosed (<5yr) Type 2 Diabetes Mellitus by Echocardiography and also to determine association of glycemic status (by HBA1c levels) with left ventricular diastolic dysfunction (LVDD).Methods: An observational descriptive study involving 100 diabetic patients, taken on first come first serve basis after applying inclusion and exclusion criteria. In all the subjects, other than routine investigations, HbA1c was estimated and echocardiography was done to evaluate LVDD.Results: Mean value of HbA1c in the study was 8.31+ 1.408 %. 63 out of 100 subjects had LVDD. There was significant positive correlation between HbA1c and LVDD (p value <0.001). As HbA1c increased, severity of LVDD increased. In this study, as BMI increased, HbA1c and LVDD increased & both findings were statistically significant (p value =0.001).Conclusion: Our study indicates that myocardial damage in patients with diabetes affects diastolic function before systolic function &higher HbA1C level is strongly associated with presence of LVDD. Patients should be advised strict control of diabetes in order to reduce the risk for developing LVDD which is a precursor for more advanced disease.Keywords: Diabetes mellitus, Diastolic dysfunction, BMI, HbA1c


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