Key result
Coronary atherosclerosis in type 2 diabetic patients was associated with more impaired LV global longitudinal strain compared to those without atherosclerosis (-18.0% vs. -16.3%, P<0.001).
Why the study?
Does subclinical left ventricular systolic dysfunction (assessed by GLS) independently predict the presence of subclinical coronary atherosclerosis in asymptomatic patients with type 2 diabetes?
Cross-Sectional (n=234)
Does subclinical left ventricular systolic dysfunction (assessed by GLS) independently predict the presence of subclinical coronary atherosclerosis in asymptomatic patients with type 2 diabetes?
p-value: p=<0.001
In asymptomatic patients with type 2 diabetes, impaired left ventricular global longitudinal strain is independently associated with subclinical coronary atherosclerosis and provides incremental predictive value over standard clinical variables.
Reduced GLS associated with CAC in asymptomatic T2DM; leaves open incremental value for risk stratification.
AIMS: The aim of the present study was to evaluate whether subclinical left ventricular (LV) systolic dysfunction is independently related to subclinical coronary atherosclerosis in type 2 diabetic patients and if it could provide incremental information over baseline characteristics to identify high-risk patients. METHODS AND RESULTS: A total of 234 asymptomatic, type 2 diabetic patients without overt LV systolic dysfunction underwent coronary artery calcium (CAC) scoring and two-dimensional echocardiography. The LV global longitudinal strain (GLS) was assessed using automated function imaging. Patients with coronary atherosclerosis (CAC > 0; n = 139) had more impaired GLS when compared with patients without coronary atherosclerosis (CAC = 0; n = 95; -18.0 ± 2.8 vs. -16.3 ± 3.0%, P < 0.001). At multivariate analysis, male gender, hypertension, hypercholesterolaemia, and the LV GLS were independently associated with coronary atherosclerosis. The addition of the LV GLS to other selected independent clinical variables significantly improved the ability to predict coronary atherosclerosis in these patients (χ(2) = 58.92; P = 0.001). CONCLUSION: Type 2 diabetic patients with coronary atherosclerosis showed a more impaired LV GLS compared with patients without coronary atherosclerosis. The presence of subclinical LV systolic dysfunction provides significant incremental value for the identification of diabetic patients having coronary atherosclerosis.
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Scholte et al. (2010) conducted a cross-sectional in Type 2 diabetes (n=234). Coronary atherosclerosis (CAC > 0) vs. No coronary atherosclerosis (CAC = 0) was evaluated on LV global longitudinal strain (GLS) (p=<0.001). Coronary atherosclerosis in type 2 diabetic patients was associated with more impaired LV global longitudinal strain compared to those without atherosclerosis (-18.0% vs. -16.3%, P<0.001).
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