scholarly journals Subclinical left ventricular dysfunction in patients with type 2 diabetes mellitus

2020 ◽  
Vol 66 (1) ◽  
pp. 56-63
Author(s):  
Vladimir A. Tsvetkov ◽  
Evgeniy S. Krutikov ◽  
Svetlana I. Chistyakova
Keyword(s):  
Heart Failure ◽  
Type 2 Diabetes ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Clinical Signs ◽  
Left Ventricular ◽  
Lv Dysfunction ◽  
High Prevalence ◽  
Concomitant Hypertension

BACKGROUND: Recent studies have shown a high prevalence of asymptomatic forms of heart failure in patients with type 2 diabetes mellitus. The presence of even subclinical forms of heart failure in type 2 DM is associated with a negative prognosis of the disease, leading to a significant increase in the frequency of hospitalizations and mortality. AIMS: Identification of left ventricle subclinical dysfunction in terms of its diastolic function, deformation parameters and rotational properties of the myocardium in patients with type 2 diabetes. METHODS: A prospective case-control single-center study, performed simultaneously in groups of patients with type 2 diabetes and hypertension. To identify left ventricular dysfunction (LV), an echocardiographic study was performed, including tissue dopplerography and Speckle Tracking Echocardiography in 2D and 3D modes. RESULTS: We examined four groups of patients comparable in age and sex distribution, with no obvious clinical signs of heart failure. Group I comprised 56 patients with type 2 diabetes and moderate hypertension. Group II included 52 patients with type 2 diabetes without an increase of blood pressure. Group III (54 people) consisted of patients with essential II degree hypertension without diabetes. Group IV (control) 30 healthy individuals. The use of tissue dopplerography and Speckle Tracking Echocardiography allows more often (p0.05) to detect signs of LV dysfunction in patients with type 2 diabetes compared with routine echocardiography methods. It was found that in patients with a combination of type 2 diabetes and moderate hypertension, a prognostically unfavorable restrictive variant of diastolic dysfunction is more common (p0.05) in contrast to patients with diabetes without hypertension or those with hypertension without diabetes. The combination of type 2 diabetes and hypertension to a greater extent leads to an increase in the longitudinal global deformation of the left ventricle compared with patients who had only one of these diseases (p0.05). A decrease in the global area strain, an early marker of LV systolic dysfunction, was expressed (p0.05) in patients with type 2 diabetes, regardless of the presence of concomitant hypertension. CONCLUSIONS: This study shows the importance of using tissue dopplerography and Speckle Tracking Echocardiography in the diagnosis of subclinical heart failure. The results indicate a high prevalence of subclinical systolic-diastolic LV dysfunction in type 2 diabetes, which is aggravated in the presence of concomitant hypertension in patients without obvious clinical signs of heart failure and other cardiovascular diseases.

scholarly journals High prevalence of previously unknown heart failure and left ventricular dysfunction in patients with type 2 diabetes

Diabetologia ◽  
2012 ◽  
Vol 55 (8) ◽  
pp. 2154-2162 ◽  
Author(s):  
L. J. M. Boonman-de Winter ◽  
F. H. Rutten ◽  
M. J. M. Cramer ◽  
M. J. Landman ◽  
A. H. Liem ◽  
...  
Keyword(s):  
Heart Failure ◽  
Type 2 Diabetes ◽  
Left Ventricular Dysfunction ◽  
Ventricular Dysfunction ◽  
Left Ventricular ◽  
High Prevalence

Speckle tracking echocardiography in the assessment of mouse models of cardiac dysfunction

2009 ◽  
Vol 297 (2) ◽  
pp. H811-H820 ◽  
Author(s):  
Yu Peng ◽  
Zoran B. Popović ◽  
Nikolai Sopko ◽  
Jeannie Drinko ◽  
Zheng Zhang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mouse Models ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Radial Strain ◽  
Left Ventricular ◽  
Cross Sectional ◽  
Isoflurane Anesthesia ◽  
Lv Dysfunction ◽  
Lv Mass

Two-dimensional (2-D) speckle tracking echocardiography (STE) accurately quantifies circumferential strain ( Scirc) and radial strain ( Srad) in humans and in large and small animals. This study was performed to assess sensitivity of Scirc and Srad to left ventricular (LV) dysfunction in mouse models. We performed 2-D and M-mode echocardiography 1) in 6 mice during superficial and profound isoflurane anesthesia, 2) serially in 12 mice to monitor the development of heart failure induced by transverse aortic constriction (TAC) and in 8 corresponding control mice, and 3) in 26 mice with varying degrees of TAC-induced heart failure and 12 corresponding control mice immediately before euthanasia. Fractional shortening (FS) and LV mass were measured from standard M-mode tracings, whereas Scirc and Srad were derived by STE. Percent fibrosis and myocyte diameters were assessed from whole heart cross-sectional specimens stained by Masson trichrome. Profound isoflurane anesthesia decreased Scirc ( P = 0.027) but not Srad ( P > 0.05). Mice subjected to TAC showed an immediate and sustained decrease in FS ( P = 0.035), Scirc ( P = 0.016), and Srad ( P = 0.012). Scirc showed better correlation with FS ( r = 0.56 and P < 0.0001) and LV mass ( r = 0.42 and P = 0.0003) than Srad ( r = 0.54 and P < 0.0001 for FS and r = 0.37 and P = 0.014 for LV mass, respectively). Percent fibrosis correlated better with Scirc ( r = 0.46 and P = 0.004) than with Srad ( r = −0.32 and P = 0.05), whereas myocyte diameter showed similar correlation with both strains ( r = 0.45 and r = −0.44, respectively, and P = 0.006 for both). STE correctly identifies LV dysfunction and histological changes in mice and can be used for the serial assessment of cardiac remodeling in murine models.

scholarly journals The Systolic and Diastolic Cardiac Function of Patients With Type 2 Diabetes Mellitus: An Evaluation of Left Ventricular Strain and Torsion Using Conventional and Speckle Tracking Echocardiography

2022 ◽  
Vol 12 ◽  
Author(s):  
Qing-mei Yang ◽  
Jian-xiu Fang ◽  
Xiao-yan Chen ◽  
Hong Lv ◽  
Chun-song Kang
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Peak Velocity ◽  
Microvascular Complications ◽  
Mitral Annulus ◽  
Left Ventricular ◽  
Control Group

Objectives: This study aimed to quantify left ventricular (LV) myocardial strain and torsion in patients with type 2 diabetes mellitus (T2DM) and evaluate their systolic and diastolic function using conventional and speckle tracking echocardiography.Methods: Forty-seven patients with T2DM were divided into a group without microvascular complications (the DM A group) and a group with microvascular complications (the DM B group), while another 27 healthy participants acted as the control group. All the participants had had an echocardiography examination. All the original data were imported into EchoPAC workstation for the analysis and quantification of LV strain and torsion.Results: Compared with the control group, the LV end-diastolic volume, end-systolic volume, and ejection fraction of the DM A and DM B groups showed no significant differences, but the global longitudinal strain and the global circular strain were reduced in the DM B group. There were significant differences in the left ventricular relative wall thickness (RWT), left ventricular mass index (LVMI), the early mitral valvular blood flow velocity peak/left ventricular sidewall mitral annulus late peak velocity, left ventricular sidewall mitral annulus early peak velocity/left ventricular sidewall mitral annulus late peak velocity, isovolumic relaxation time, peak twisting, peak untwisting velocity (PUV), untwisting rate (UntwR), time peak twisting velocity (TPTV), and time peak untwisting velocity (TPUV) between the DM A, DM B, and control groups. While the peak twisting velocity (PTV) was slower in the DM B group compared with the control group, the RWT, PTV, PUV, UntwR, TPTV, and TPUV in the DM B group were significantly different from the DM A group.Conclusion: The cardiac function of patients with T2DM in its early stages, when there are no microvascular complications, could be monitored with the analysis of two-dimensional strain and torsion.

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