Type 2 diabetic subjects with normal conventional echocardiography showed early diastolic impairment on tissue Doppler imaging compared to controls, evidenced by a reduced Ea/Aa ratio (1.00 vs 1.39, P<0.0001).
Observational (n=60)
Does tissue Doppler imaging detect pre-clinical impairment of diastolic function in non-obese, normotensive Type 2 diabetic subjects with normal cardiac function on conventional echocardiography?
Tissue Doppler imaging can detect early pre-clinical diastolic dysfunction in Type 2 diabetic patients who appear to have normal cardiac function on conventional echocardiography, and this impairment is associated with insulin resistance.
Absolute Event Rate: 1% vs 1.39%
p-value: p=<0.0001
OBJECTIVE: The aim of the study was to evaluate whether tissue Doppler imaging (TDI) detects a pre-clinical impairment of diastolic function in subjects with Type 2 diabetes with short duration of disease and normal cardiac function with conventional echocardiography (CE), and whether echocardiographic parameters are related to metabolic abnormalities. PATIENTS AND METHODS: We studied 40 non-obese, normotensive, uncomplicated Type 2 diabetic subjects with short duration of disease and 20 control subjects. All participants underwent both CE and TDI echocardiography. With TDI, early velocity (Ea), atrial velocity (Aa), their ratio (Ea/Aa) and systolic velocity (Sa) were measured at the lateral corner of mitral annulus. Glycosylated haemoglobin, fasting plasma glucose and insulin were determined and homeostasis model assessment (HOMA-IR), as an index of insulin resistance, was calculated. RESULTS: Cardiac function with CE was similar in the two groups. Using TDI, diabetic subjects showed a lower Ea velocity (15.5+/-3.9 vs. 19.4+/-3.5 cm/s, P<0.0001), an increased Aa velocity (15.5+/-2.4 vs. 14.1+/-2.4 cm/s, P<0.05) and a reduced Ea/Aa ratio (1.00+/-0.2 vs. 1.39+/-0.3, P<0.0001), compared with control subjects. Linear regression analysis in the diabetic group showed that only HOMA-IR was negatively associated with Ea/Aa ratio (P=0.026). No significant association was observed with other metabolic variables. CONCLUSION: An early stage of diabetic cardiomyopathy can be evidenced by TDI in Type 2 diabetic subjects even in the presence of a normal cardiac function with CE. This abnormality is associated with insulin resistance.
Bonito et al. (Thu,) conducted a observational in Type 2 diabetes (diabetic cardiomyopathy) (n=60). Type 2 diabetes vs. Control subjects was evaluated on Ea/Aa ratio measured by tissue Doppler imaging (p=<0.0001). Type 2 diabetic subjects with normal conventional echocardiography showed early diastolic impairment on tissue Doppler imaging compared to controls, evidenced by a reduced Ea/Aa ratio (1.00 vs 1.39, P<0.0001).
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