Mami Enomoto1, Tomoko Ishizu2, Yoshihiro Seo1, Yuri Kameda3, Hiroaki Suzuki4, Hiroshi Shimano4, Yasushi Kawakami5, Kazutaka Aonuma1. 1. Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan. 2. Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan; Department of Clinical Laboratory Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan. Electronic address: tomoco@md.tsukuba.ac.jp. 3. Department of Medical Sciences, University of Tsukuba, Tsukuba, Japan. 4. Division of Endocrinology and Metabolism, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan. 5. Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan; Department of Clinical Laboratory Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Abstract
BACKGROUND: The clinical effect of diabetic microangiopathy on left ventricular (LV) function is still uncertain. The purpose of this study was to assess the relation between diabetic microvascular complications and comprehensive myocardial deformation measurements using three-dimensional (3D) speckle tracking echocardiography. METHODS: Seventy-seven asymptomatic patients with type 2 diabetes mellitus (DM) and 35 age-matched healthy control subjects underwent 3D echocardiography. Patients with coronary artery disease or LV ejection fraction <50% were excluded. Presence of proliferative retinopathy, microalbuminuria as nephropathy, and decreased coefficient of variation of R-R intervals (CVRR) <3% as cardiac autonomic neuropathy were defined as diabetic microvascular complications. RESULTS: LV ejection fraction, LV mass index, and global radial strain did not differ between control and DM patients. However, global longitudinal and circumferential strain and endocardial area change ratio were lower in patients with DM than in the controls (-12.0±3.0% vs. -16.2±1.9%, -27.7±7.1% vs. 32.2±5.7%, -37.6±7.6% vs. 44.0±6.2%, respectively, p<0.001). In DM patients, longitudinal strain is related to CVRR (R=0.58, p<0.001), retinopathy stage, and nephropathy stage. CONCLUSIONS: Diabetic microangiopathy and its accumulated effects significantly related to subclinical LV dysfunction are characterized by impaired longitudinal shortening.
BACKGROUND: The clinical effect of diabetic microangiopathy on left ventricular (LV) function is still uncertain. The purpose of this study was to assess the relation between diabetic microvascular complications and comprehensive myocardial deformation measurements using three-dimensional (3D) speckle tracking echocardiography. METHODS: Seventy-seven asymptomatic patients with type 2 diabetes mellitus (DM) and 35 age-matched healthy control subjects underwent 3D echocardiography. Patients with coronary artery disease or LV ejection fraction <50% were excluded. Presence of proliferative retinopathy, microalbuminuria as nephropathy, and decreased coefficient of variation of R-R intervals (CVRR) <3% as cardiac autonomic neuropathy were defined as diabetic microvascular complications. RESULTS: LV ejection fraction, LV mass index, and global radial strain did not differ between control and DMpatients. However, global longitudinal and circumferential strain and endocardial area change ratio were lower in patients with DM than in the controls (-12.0±3.0% vs. -16.2±1.9%, -27.7±7.1% vs. 32.2±5.7%, -37.6±7.6% vs. 44.0±6.2%, respectively, p<0.001). In DMpatients, longitudinal strain is related to CVRR (R=0.58, p<0.001), retinopathy stage, and nephropathy stage. CONCLUSIONS:Diabetic microangiopathy and its accumulated effects significantly related to subclinical LV dysfunction are characterized by impaired longitudinal shortening.
Authors: Jun Huang; Hai-Ling Hu; Zi-Ning Yan; Li Fan; Yi-Fei Rui; Dan Shen; Jie Li Journal: BMC Cardiovasc Disord Date: 2019-06-07 Impact factor: 2.298