Left ventricular radial systolic dysfunction in diabetic patients assessed by myocardial acceleration derived from velocity vector imaging.

OBJECTIVES: The purpose of this study was to determine whether left ventricular (LV) radial systolic dysfunction occurred in diabetic patients with a normal left ventricular ejection fraction (LVEF) and impaired longitudinal contraction.
METHODS: Velocity vector imaging was performed in 22 patients with type 2 diabetes without microangiopathy (12 men and 10 women; mean age ± SD, 49 ± 7 years), 21 patients with microangiopathy (12 men and 9 women; mean age, 50 ± 6 years), and 21 healthy control participants (11 men and 10 women; mean age, 49 ± 8 years). The groups were matched for age and sex. All had no clinical symptoms of heart disease, coronary artery disease, or hypertension.
RESULTS: The LVEF, fractional shortening, and end-diastolic diameter were statistically comparable in all groups. The left ventricular wall thickness was significantly greater in diabetic patients than controls (P < .05). Average peak early diastolic accelerations at all LV levels were significantly lower in diabetic patients than controls in the long-and short-axis directions (all P < .05). In the long-axis direction, a significantly lower average peak isovolumic contraction acceleration was found at the mid and apical levels in patients without microangiopathy and at all LV levels in patients with microangiopathy than controls (all P < .05). In the short-axis direction, a significantly lower average isovolumic contraction acceleration was found at the apical level in patients without microangiopathy and at the basal and apical levels in patients with microangiopathy (all P < .05).
CONCLUSIONS: In diabetic patients with a normal LVEF, myocardial systolic dysfunction occurs not only in the long-axis direction but also in the short-axis direction.