Left ventricular subepicardial longitudinal strain was significantly reduced (e.g., 16.40 vs 20.45 in three-chamber view, P < 0.05) in diabetes patients compared to healthy controls, with greater impairment in those with left ventricular remodeling.
Cross-Sectional (n=60)
No
Does two-dimensional speckle tracking echocardiography detect early left ventricular systolic dysfunction in diabetes patients with preserved ejection fraction compared to healthy controls?
Layer-specific longitudinal strain analysis using 2D speckle tracking echocardiography can detect early subclinical left ventricular systolic dysfunction in diabetes patients with preserved ejection fraction, particularly in the epicardial layer.
Effect estimate: P < 0.05 (significant decrease in strain in diabetes patients vs controls)
Absolute Event Rate: 16.4% vs 20.45%
p-value: p=<0.05
To explore the application of left ventricular (LV) stratified strain in evaluating early systolic dysfunction in diabetes patients with and without LV remodeling by using two-dimensional speckle tracking echocardiography (2DSTE), This study included 35 diabetes patients and 25 healthy individuals. All participants completed echography by GE Vivid E9 ultrasound system. The diabetes patients were subdivided based on relative wall thickness into normal LV geometry group and LV remodeling group. The EchoPAC offline workstation was used to analyze LV myocardial longitudinal layer-specific strain. Our results showed that compared to the control group, the absolute values of longitudinal strain in the endocardial, mid-myocardial, and epicardial layers of the 3-chamber view, the epicardial layer of the 4-chamber view, as well as the average longitudinal strain of the mid-myocardial and epicardial layers across all three views, were significantly decreased in the diabetes group (P 0.05). Compared to the control group, both the normal LV geometry and LV remodeling subgroups showed significantly reduced absolute values of longitudinal strain in the epicardial layer of the 3-chamber and 4-chamber views, and in the average epicardial strain across all three views (P 0.05), with the most pronounced changes observed in the LV remodeling group. Furthermore, compared to the control group, the LV remodeling subgroup exhibited significantly reduced absolute values of longitudinal strain in the endocardial and mid-myocardial layers of the 3-chamber view, the endocardial layer of the 4-chamber view, and the average mid-myocardial strain across all three views (P 0.05). A significant decrease in the absolute value of epicardial longitudinal strain in the 3-chamber view was also found in the LV remodeling group compared to the normal LV geometry group (P 0.05). The study reveals that in diabetes patients with either normal LV geometry or LV remodeling, impairment of epicardial longitudinal strain in the 3-chamber and 4-chamber views, as well as the average epicardial strain, occurs earlier. In diabetes patients with LV remodeling, longitudinal strain in the endocardial and mid-myocardial layers of the 3-chamber view, the endocardial layer of the 4-chamber view, and the average mid-myocardial strain were the most sensitively impaired parameters. Additionally, the impairment of myocardial longitudinal strain was most pronounced in the apical 3-chamber view.
Li et al. (Thu,) conducted a cross-sectional in Adults with diabetes mellitus and preserved left ventricular ejection fraction (LVEF ≥ 55%) undergoing evaluation for left ventricular function with and without left ventricular remodeling (n=60). Left ventricular layered longitudinal strain measurement using two-dimensional speckle tracking echocardiography (2DSTE) vs. Healthy control group was evaluated on Absolute values of left ventricular longitudinal strain in subendocardial, mid-myocardial, and subepicardial layers from apical three-chamber, four-chamber, and two-chamber views (P < 0.05 (significant decrease in strain in diabetes patients vs controls), p=<0.05). Left ventricular subepicardial longitudinal strain was significantly reduced (e.g., 16.40 vs 20.45 in three-chamber view, P < 0.05) in diabetes patients compared to healthy controls, with greater impairment in those with left ventricular remodeling.