Assessment of left ventricular function by three‐dimensional speckle‐tracking echocardiography in well‐treated type 2 diabetes patients with or without hypertension

PURPOSE: The aims of this study were to investigate the myocardial deformation in well-treated type 2 diabetes patients with or without hypertension using three-dimensional speckle-tracking echocardiography and to explore variables that could affect myocardial deformation. METHODS: We studied 82 patients with type 2 diabetes and controlled blood glucose, including 46 subjects with diabetes alone and 36 subjects with diabetes and well-controlled hypertension, and 40 age- and gender-matched controls. Left ventricular real-time three-dimensional (3D) full-volume images were recorded and analyzed using online software. The left ventricular ejection fraction, global longitudinal strain (GLS), global circumferential strain, global area strain, and global radial strain were measured and compared. RESULTS: Despite a similar three-dimensional left ventricular ejection fraction, GLS was significantly lower in patients with diabetes only than in controls (p < 0.001). Patients with diabetes and hypertension showed significantly lower systolic strains in all directions than controls and patients with diabetes only (p < 0.001 and p < 0.05, respectively). Multiple regression analysis revealed that fasting plasma glucose and left ventricular end-diastolic volume were significant factors influencing GLS in both diabetic groups. CONCLUSIONS: Early-stage diabetic patients showed an impaired left ventricular strain that was worsened by coexistent hypertension, although blood glucose and blood pressure were well controlled. Three-dimensional speckle-tracking echocardiography was able to detect these subclinical changes.