Fat Mass is Associated with Subclinical Left Ventricular Systolic Dysfunction in Patients with Type 2 Diabetes Mellitus Without Established Cardiovascular Diseases

Figures

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  Fig. 1. Flow chart of the study

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  Fig. 2. Bull’s-eye views of the peak systolic myocardial longitudinal strain of patients with type 2 diabetes mellitus (T2DM) and subclinical left ventricular systolic dysfunction. Observations of strain values are shown in three different cardiac views: the four-chamber view (4CH), the two-chamber view (2CH), and the apical long-axis view (APLAX) view. Strain curves are plotted as changes in myocardial strain values over one cardiac cycle in the left ventricle. Different colors represent different segments of the myocardium, and the stages of the cardiac cycle are marked by the electrocardiogram under the strain curves. The peak strain values for all segments are summarized as a bull's-eye plot, with each segment's peak strain value indicated by a numerical value within the plot. The average of all segmental peak strain values represents the global longitudinal strain (GS). In this study, the GLS of the left ventricle was 15.0%, which is below the normal cutoff point

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  Fig. 3. Bull’s-eye views of the peak systolic myocardial longitudinal strain of patients with T2DM but without subclinical left ventricular systolic dysfunction. Observations of strain values in three different cardiac views: 4CH, 2CH, and APLAX. Strain curves are plotted as changes in myocardial strain values over one cardiac cycle in the left ventricle. Different colors represent different segments of the myocardium, and the stages of the cardiac cycle are marked by the electrocardiogram under the strain curves. The peak strain values for all segments are summarized as a bull's-eye plot, with each segment's peak strain value indicated by a numerical value within the plot. The average of all segmental peak strain values represents the global longitudinal strain (GS). In this study, the GS of the left ventricle was 20.8%, which is normal

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  Fig. 4. Box plot comparing global longitudinal strain (GLS) after tertile grouping (T1, T2, T3) based on parameters related to body composition. A GLS in tertiles of android fat mass, B GLS in tertiles of truck fat mass, C GLS in tertiles of fat mass index, D GLS in tertiles of body mass index. Asterisks indicate a significant difference between tertiles at *p < 0.05, **p < 0.01, and ***p < 0.001 (Turkey’s test). NS Not significant