Prediction of Subclinical Left Ventricular Systolic Dysfunction by Mitral Annular Plane Systolic Excursion in M-Mode Echocardiography in Correlation to Speckle Tracking by 2-Dimensional Echocardiography and Tissue Doppler Imaging in Patients With Type 2 Diabetes Mellitus

Background: Diabetes mellitus (DM) is considered as a major risk factor for heart failure with preserved Ejection fraction (EF). Using M-Mode echocardiographic method may be useful in prediction of early LV systolic dysfunction in patient with type II diabetes mellitus by measurement of mitral annular plane systolic excursion (MAPSE) in correlation to global longitudinal strain (GLS) and to tissue Doppler imaging (TDI). Objective: To emphasize on the usefulness of M-mode echocardiographic methods like the mitral annular plane systolic excursion (MAPSE) correlated to speckle tracking by 2 dimensional (STE) and tissue Doppler imaging in prediction of subclinical LV systolic dysfunction in patients with type 2 diabetes. Patients and methods: The study included 100 asymptomatic patients with type II DM and 50 healthy subjects as a control group. Echocardiography was performed to all of them All cases were recruited from the outpatient clinic in Maadi military Hospital in Cairo. Results: The study included 100 asymptomatic patients with type II DM, 65 of them were females, and 50 healthy subjects as a control group, 27 of them were females. MAPSE were significantly lower in DM group [1.2 (1.1 – 1.25) cm] compared to control group [1.4 (1.3 – 1.5) cm] (p < 0.001). MAPSE linearly had a significant positive correlation with EF, GLS and Sa wave [r= 0.565, 0.723, 0.595 respectively], (p < 0.01). MAPSE linearly had a significant negative correlation with DM duration and HbA1C Level [r= -0.495, -0.776 respectively], (p < 0.01). Average MAPSE at a cut-off point (≤1.2cm) with good (82%) accuracy, sensitivity= 68% and specificity= 82% (p < 0.01). Conclusions: MAPSE is a useful M-mode method in prediction of subclinical LV systolic dysfunction in asymptomatic type II diabetic patients, and it has a positive correlation to GLS and Sa wave of TDI. It has a negative correlation with duration of DM and HbA1C level.