Assessment of left ventricular function in type 2 diabetes mellitus patients with non-alcoholic fatty liver disease by three-dimensional speckle tracking echocardiography

Yu, Dongbo; Cui, Hongyan; Sun, Lihua; Wang, Ying; Liu, Ying; Chang, Wenxing; Li, Guangsen; Huang, Dongmei

doi:10.14744/anatoljcardiol.2019.66805

Cited by 8 publications

(10 citation statements)

References 44 publications

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“…This indicated that longitudinal strain was more susceptible to change than circumferential strain in the LV of patients with diabetes. It is possible that the LV endocardium, the myocardial fibers of which are predominantly distributed longitudinally, is the first to be damaged by hyperglycemia or free fatty acids, which endows the longitudinal strain with higher statistical significance than circumferential strain 28 . This result is consistent with the reported findings of many previous studies.…”

Section: Discussionmentioning

confidence: 99%

Feasibility study of automated cardiac motion quantification to assess left ventricular function in type 2 diabetes

2023

Sci Rep

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The global incidence of diabetes and related complications is gradually increasing, with cardiovascular complications being the leading cause of death in the diabetic population. The purpose of this study was to examine left ventricular function in individuals with type 2 diabetes mellitus (T2D) and conduct a feasibility analysis using automated cardiac motion quantification (aCMQ) approach. A total of 150 T2D patients with a history of diabetes mellitus dating back more than 10 years were chosen, and we treated 87 patients with T2D that had been present for less than 15 years as group I, 63 patients with T2D that had been present for more than 15 years as group II, and 50 healthy volunteers as the control group. From the three groups, clinical information, conventional ultrasonography parameters, and mitral annular plane systolic excursion (MAPSE) parameters were gathered. aCMQ technique was used to collect longitudinal strain and circumferential strain in the left ventricle. Tissue motion mitral annular displacement technique (TMAD) in aCMQ was used to collect parameters related to TMAD, and cardiac motion quantification (CMQ) was used to collect two-dimensional global longitudinal strain (2D-GLS) to compare the degree of difference between the aforementioned three groups. The differences between longitudinal strain groups in aCMQ were all statistically significant and gradually decreased with increasing disease duration. Most TMAD parameters were lower in groups I and II than in the control group, and TMAD parameters gradually decreased with increasing disease duration. The results of the LV global longitudinal strain and 2D-GLS using Bland–Altman analyses showed high agreement between and within groups, Pearson correlation analysis showed a significant positive correlation (r = 0.18, P < 0.05), and the AUC of ROC curves predicting the value of left ventricular function in patients with T2D was 0.723 and 0.628, respectively. With significant positive correlations between MAPSE, s', and the majority of the TAMD parameters (P < 0.05), TAMD, MAPSE, and s' demonstrated high inter- and intra-group agreement using Bland–Altman analyses, and the three had predictive value in assessing left ventricular function in T2D patients by ROC curve. Reduced longitudinal strain and reduced mitral annular displacement were seen in patients with different disease stages of T2D, so the application of aCMQ and TAMD was effective in detecting altered left ventricular function in patients with T2D. aCMQ had higher value in predicting left ventricular function in patients with T2D compared to CMQ for overall longitudinal strain, and the software performed the depiction automatically, reducing manual errors. MAPSE parameters and s ' can replace the TMAD technique for assessing mitral annular motion and was simpler to perform, saving operational time.

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Section: Discussionmentioning

confidence: 99%

Feasibility study of automated cardiac motion quantification to assess left ventricular function in type 2 diabetes

2023

Sci Rep

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“…A 2019 meta-analysis of 16 observational studies further confirmed that NAFLD (as detected by imaging techniques or liver biopsy) was independently associated with many functional and structural myocardial abnormalities, including higher left ventricle mass, higher left ventricular end diastolic diameter, higher left atrium diameter and the ratio between left atrial volume and body surface area, higher posterior wall and septum thickness, lower E/A wave ratio, higher E/E ratio, longer deceleration time and longer relaxation time [58]. Interestingly, recent observational studies also indicated that NAFLD (as detected by ultrasonography) was associated with a reduction in global longitudinal strain, which is a relatively novel echocardiographic parameter strongly associated with adverse cardiovascular outcomes [59][60][61]. NAFLD was associated with an increased risk of incident CKD (random-effects hazard ratio 1.43, 95% confidence interval 1.33-1.54)…”

Section: Sub-clinical Myocardial Remodelling and Dysfunction Heart Va...mentioning

confidence: 99%

Non-Alcoholic Fatty Liver Disease and Risk of Macro- and Microvascular Complications in Patients with Type 2 Diabetes

Mantovani

Dalbeni

Beatrice

et al. 2022

JCM

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Non-alcoholic fatty liver disease (NAFLD) is considered the hepatic manifestation of metabolic syndrome. To date, NAFLD is the most frequent chronic liver disease seen day by day in clinical practice across most high-income countries, affecting nearly 25–30% of adults in the general population and up to 70% of patients with T2DM. Over the last few decades, it clearly emerged that NAFLD is a “multisystemic disease” and that the leading cause of death among patients with NAFLD is cardiovascular disease (CVD). Indeed, several observational studies and some meta-analyses have documented that NAFLD, especially its advanced forms, is strongly associated with fatal and non-fatal cardiovascular events, as well as with specific cardiac complications, including sub-clinical myocardial alteration and dysfunction, heart valve diseases and cardiac arrhythmias. Importantly, across various studies, these associations remained significant after adjustment for established cardiovascular risk factors and other confounders. Additionally, several observational studies and some meta-analyses have also reported that NAFLD is independently associated with specific microvascular conditions, such as chronic kidney disease and distal or autonomic neuropathy. Conversely, data regarding a potential association between NAFLD and retinopathy are scarce and often conflicting. This narrative review will describe the current evidence about the association between NAFLD and the risk of macro- and microvascular manifestations of CVD, especially in patients with T2DM. We will also briefly discuss the biological mechanisms underpinning the association between NAFLD and its advanced forms and macro- and microvascular CVD.

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“…This forms a basis for the importance of cardiac assessment in diabetic patients with moderate to severe NAFLD to allow early clinical intervention and treatment. 82 LV remodeling and hypertrophy are complications seen in diabetic patients and were suggested to have a causative contribution to GLS reduction. 83 …”

Section: Speckle Tracking Echocardiographymentioning

confidence: 99%

Advanced Echocardiography Techniques: The Future Stethoscope of Systemic Diseases

Iskander

Kelada

Rashad

et al. 2022

Current Problems in Cardiology

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Assessment of left ventricular function in type 2 diabetes mellitus patients with non-alcoholic fatty liver disease by three-dimensional speckle tracking echocardiography

Cited by 8 publications

References 44 publications

Feasibility study of automated cardiac motion quantification to assess left ventricular function in type 2 diabetes

Feasibility study of automated cardiac motion quantification to assess left ventricular function in type 2 diabetes

Non-Alcoholic Fatty Liver Disease and Risk of Macro- and Microvascular Complications in Patients with Type 2 Diabetes

Advanced Echocardiography Techniques: The Future Stethoscope of Systemic Diseases

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