Key result
Untreated normotensive patients with type 2 diabetes mellitus had significantly impaired global longitudinal 3DE strain compared to healthy controls (-17.8% vs. -19.1%, P=0.014).
Cross-Sectional (n=100)
Absolute Event Rate: -17.8% vs -19.1%
p-value: p=0.014
Untreated normotensive patients with type 2 diabetes mellitus exhibit significantly impaired left ventricular deformation on 3D echocardiography, which is independently associated with HbA1c levels.
Detects subclinical LV dysfunction in normotensive T2DM via 3DE strain; leaves open its prognostic value and clinical utility.
BACKGROUND: Our aim was to investigate left ventricular (LV) mechanics estimated by two- (2DE) and three-dimensional echocardiography (3DE) strains in subjects with type 2 diabetes mellitus (DM). METHODS: This cross-sectional study included 50 untreated normotensive DM subjects and 50 healthy controls similar by sex and age. All the subjects underwent adequate laboratory analyses and complete 2DE and 3DE examination. RESULTS: Left ventricular mechanics, assessed by 2DE, was impaired in all three directions. Global longitudinal 3DE strain was significantly decreased in the DM group in comparison with the controls (-17.8 ± 2.5 vs. -19.1 ± 2.7%, P = 0.014). Similar results were found for 3DE global circumferential strain (-18.9 ± 2.9 vs. -20.4 ± 3.2%, P = 0.01), 3DE global radial strain (40.3 ± 6.9 vs. 43.1 ± 7.3%, P = 0.035), and 3DE global area strain (-29.2 ± 3.7 vs. -31 ± 4%, P = 0.024). LV torsion was similar between the DM patients and the controls (2.1 ± 0.6 vs. 1.9 ± 0.5 °/cm, P = 0.073); whereas LV untwisting rate was significantly increased in the DM subjects (-114 ± 26 vs. -96 ±23 °/s, P < 0.001). A multivariate analysis showed that 3DE global longitudinal and area myocardial functions were associated with HbA1c independently of 3DE LV mass index. CONCLUSION: Left ventricular deformation obtained by 3DE is significantly impaired in the type 2 DM patients. HbA1c is independently associated with LV mechanics that implies that early anti-diabetic therapy and normalization of the fasting glucose level and HbA1c could impede further cardiac damage.
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Tadić et al. (2014) conducted a cross-sectional in Type 2 diabetes mellitus (n=100). Type 2 diabetes mellitus vs. Healthy controls was evaluated on Global longitudinal 3DE strain (p=0.014). Untreated normotensive patients with type 2 diabetes mellitus had significantly impaired global longitudinal 3DE strain compared to healthy controls (-17.8% vs. -19.1%, P=0.014).
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