Key result
Pre-diabetes was associated with significantly lower Global Longitudinal Strain (-19.4% vs 23.8%; p<0.001) and prolonged atrial electromechanical delays compared to healthy controls.
Why the study?
Does pre-diabetes cause subclinical myocardial dysfunction as measured by left ventricular strain and atrial electromechanical delay?
Cross-Sectional (n=180)
Does pre-diabetes cause subclinical myocardial dysfunction as measured by left ventricular strain and atrial electromechanical delay?
Absolute Event Rate: -19.4% vs 23.8%
p-value: p=<0.001
Pre-diabetic patients exhibit subclinical myocardial dysfunction characterized by decreased global longitudinal strain and prolonged atrial electromechanical delay.
Pre-diabetes may indicate early subclinical cardiac impairment; leaves open whether strain imaging aids risk stratification or intervention.
The aim of this study was to investigate the subclinical myocardial affection in prediabetics with the evaluation of left ventricular (LV) systolic strain and strain rate by speckle tracking echocardiography (STE), and atrial electromechanical delay. Global Longitudinal strain (GLS) and strain rate (GLSR) were assessed by STE, and Intra- and interatrial electromechanical delay (EMD) were measured utilizing tissue Doppler imaging (TDI) in 108 pre-diabetic patients and 72 age and gender matched healthy volunteers. The GLS (− 19.4 ± 2.8 vs. 23.8 ± 2.1%; p < 0.001) and GLSR () were significantly lower in prediabetics when compared with the healthy control. Pre-diabetic patients had significantly prolonged PA lateral, PA septum and PA tricuspid. The intra- (PA septum-PA tricuspid) and interatrial (PA lateral-PA tricuspid) electromechanical delays were prolonged compared to controls (p < 0.0001, p < 0.05, p < 0.001, and p < 0.002, respectively). The GLS%, GLSR and atrial electromechanical delay were highly significantly correlated with fasting blood glucose, and modestly correlated to systolic blood pressure, total cholesterol, triglycerides, and left ventricular mass index. GLS%; GLSR assessed by STE was decreased; intra- and interatrial electromechanical delays were prolonged, in pre-diabetic subjects. These non-invasive indices broaden the spectrum of subclinical myocardial dysfunction in pre-diabetic patients.
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Mahfouz et al. (2016) conducted a cross-sectional in Pre-diabetes (n=180). Pre-diabetes vs. Healthy volunteers was evaluated on Global Longitudinal strain (GLS) (p=<0.001). Pre-diabetes was associated with significantly lower Global Longitudinal Strain (-19.4% vs 23.8%; p<0.001) and prolonged atrial electromechanical delays compared to healthy controls.
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