Assessment of regional left ventricular functions by strain and strain rate echocardiography in type II diabetes mellitus patients without microvascular complications

Alpaydın, Mehmet Sertaç; Aksakal, Enbiya; Erol, Mustafa Kemal; Şimşek, Ziya; Açıkel, Mahmut; Arslan, Şakir; Gündoğdu, Fuat; Sevimli, Serdar; Karakelleoğlu, Şule

doi:10.5543/tkda.2011.01490

Cited by 10 publications

(4 citation statements)

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“…It indicated that in the presence of diabetes, hypertension could produce more obvious LV hypertrophy and remodeling. Diabetes is a well-established risk factor for developing cardiovascular disease [ 21 ] and diabetic hypertensive patients may have more severe clinical and morphologic features of cardiovascular disease compared to those with hypertension only [ 22 , 23 ]. Recent studies in mice models further found that diabetes by itself had no overt effect on cardiac structural change, but that combined with hypertension, diabetic heart appeared to potentiate LV hypertrophic remodeling [ 24 – 26 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of hypertension with or without diabetes on left ventricular remodeling in rural Chinese population: a cross-sectional study

Chen

Guo

et al. 2017

BMC Cardiovasc Disord

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BackgroundThe aim of this study was to assess the impact of hypertension with or without diabetes on left ventricular (LV) remodeling in rural Chinese population.MethodsA total of 10,270 participants were classified into control group, hypertension without diabetes (HT) group, and hypertension with diabetes (HT + DM) group. We compared clinical characteristics and echocardiographic parameters, and used multivariable logistic regression analysis to assess the associations of interest.ResultsHT + DM group had higher interventricular septal thickness (IVSd), posterior wall thickness (PWTd), left ventricular mass (LVM), LVM index (LVMI), relative wall thickness (RWT), left atrial diameter (LAD), A wave and lower E wave than HT group (all P < 0.05). The prevalence rates of left ventricular hypertrophy (LVH) and abnormal geometry were statistically different among three groups (P < 0.001) and eccentric hypertrophy was the highest proportion of geometry abnormality. Logistic regression analysis suggested that subjects in HT and HT + DM groups had odds ratio (OR) values of 2.81, 4.41, 2.24 and 3.94, 7.20, 2.38 for LVH, concentric hypertrophy and eccentric hypertrophy in the total population, respectively, compared to control group. When compared with HT group, those in HT + DM group had approximately 1.40-, 1.61- and 1.38-, 1.71-fold increased risk for LVH and concentric hypertrophy in the total and female population separately, but no association of HT + DM with LVH and abnormal geometrical patterns was found in men.ConclusionsThis study demonstrated that, to varying degrees, hypertension was associated with LV remodeling in rural Chinese population, and this risk association was obviously increased for LVH and concentric hypertrophy when accompanied by diabetes, especially for women.

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Section: Discussionmentioning

confidence: 99%

Impact of hypertension with or without diabetes on left ventricular remodeling in rural Chinese population: a cross-sectional study

Chen

Guo

et al. 2017

BMC Cardiovasc Disord

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“…Strain and SR derived from SRI reflect an improved assessment of myocardial contraction and quantification of regional myocardial deformation in humans. [ 31 ] Particularly in the clinical setting, cardiovascular risk factors contributing to altered SRI measures occur before the development of global LV dysfunction. [ 32 ] In addition, the technology's allure lies primarily in its portability, relative affordability, widespread availability, noninvasive nature, and rapid real-time imaging capabilities.…”

Section: Onclusionsmentioning

confidence: 99%

Early Detection of Regional and Global Left Ventricular Myocardial Function Using Strain and Strain-rate Imaging in Patients with Metabolic Syndrome

Wang

Sun

et al. 2015

Chinese Medical Journal

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Background:Strain and strain-rate imaging (SRI) have been found clinically useful in the assessment of cardiac systolic and diastolic function as well as providing new insights in deciphering cardiac physiology and mechanics in cardiomyopathies, and identifying early subclinical changes in various pathologies. The aim of this study was to evaluate the regional and global left ventricular (LV) myocardial function in metabolic syndrome (MS) with SRI so that we can provide more myocardial small lesions in patients with MS, which is robust and reliable basis for early detection of LV function.Methods:Thirty-nine adults with MS were enrolled in the study. There was a control group of 39 healthy adults. In addition to classic echocardiographic assessment of LV global functional changes, SRI was used to evaluate regional and global LV function. Including: Peak systolic strain (S), peak systolic strain-rate (SR-s), peak diastolic strain-rate (SR-e).Results:There were no statistically significant differences between MS and controls in all traditional parameters of LV systolic function. On the other hand, significant differences were observed between MS and the control group in most of the parameters of S, SR-s, SR-e in regional LV function. Multiple stepwise regression analyses revealed that S and SR significantly were negatively correlated with blood pressure, waist circumference, fasting plasma glucose, uric acid, suggesting that risk factories were relevant to regional systolic dysfunction.Conclusion:In MS with normal LV ejection fraction, there was regional myocardial dysfunction, risk factors contributed to the impairment of systolic and diastolic function of the regional myocardium. Assessment of myocardial function using SRI could be more accurate in MS patient evaluation than conventional echocardiography alone.

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“…Patients with type 2 DM are at high risk of developing CV disease (21). In addition, the clinical and morphologic features of CV disease are more severe in hypertensive diabetic patients compared to lone hypertensive or diabetic patients (22).…”

Section: Discussionmentioning

confidence: 99%

Ambulatory arterial stiffness index is associated with impaired left atrial mechanical functions in hypertensive diabetic patients: A speckle tracking study

Kalaycıoğlu¹,

Gökdeniz²,

Aykan³

et al. 2015

Anatol J Cardiol

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Objective:The ambulatory arterial stiffness index has been proposed as an indicator of arterial stiffness. The aim of this study was to test the hypothesis that increased ambulatory arterial stiffness index might be related with impaired left atrial function in hypertensive diabetic patients with no previous history of cardiovascular disease.Methods:Inclusion criteria included office systolic BP> 130 mm Hg or diastolic BP> 80 mm Hg and absence of secondary causes of HT, whereas exclusion criteria LV ejection fraction <50%, history of significant coronary artery disease, chronic renal failure, atrial fibrillation/flutter, second or third-degree atrioventricular block, moderate to severe valvular heart disease, history of cerebrovascular disease, non-dipper hypertensive pattern and sleep apnea. The study was composed of 121 hypertensive diabetic patients. Twenty-four-hour ambulatory blood pressure monitoring and echocardiography were performed in each patient. The relationship between ambulatory arterial stiffness index and left atrial functions was analyzed. AASI was calculated as 1 minus the regression slope of diastolic BP plotted against systolic BP obtained through individual 24-h ABPM.Results:The univariate analysis showed that ambulatory arterial stiffness index was positively correlated with age (r=:0.287, p=:0.001), hypertension duration (r=:0.388, p<0.001), fasting plasma glucose (r=:0.224, p=:0.014), HbA1c (r=:0.206, p=:0.023), LDL cholesterol (r=:0.254, p=:0.005), and also overall pulse pressure (r=:0.195, p=:0.002), office-pulse pressure (r=:0.188, p=:0.039), carotid intima-media thickness (r=:0.198, p=:0.029), E/E’ (r=:0.248, p=:0.006), and left atrial volume index (r=:0.237, p=:0.009). Moreover, ambulatory arterial stiffness index was negatively correlated with eGFR (r=:(-) 0.242, p=:0.008), peak left atrial strain during ventricular systole [S-LAs (r=:(-) 0.654, p<0.001)], peak left atrial strain at early diastole [S-LAe (r=:(-)0.215, p=:0.018)], and peak left atrial strain rate during ventricular systole [SR-LAs (r=:(-) 0.607, p<0.001)]. The multiple linear regression analysis showed that ambulatory arterial stiffness index was independently associated with peak left atrial strain rate during ventricular systole (SR-LAs) (p<0.001).Conclusion:In hypertensive diabetic patients, increased ambulatory arterial stiffness index is associated with impaired left atrial functions, independent of left ventricular diastolic dysfunction.

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Assessment of regional left ventricular functions by strain and strain rate echocardiography in type II diabetes mellitus patients without microvascular complications

Abstract: The frequency of left ventricular diastolic dysfunction was higher in patients with DM. Irregular distribution of systolic S and Sr indices in the left ventricular segments may indicate that DM leads to heterogeneous myocardial involvement also in the early period.

Cited by 10 publications

References 0 publications

Impact of hypertension with or without diabetes on left ventricular remodeling in rural Chinese population: a cross-sectional study

Impact of hypertension with or without diabetes on left ventricular remodeling in rural Chinese population: a cross-sectional study

Early Detection of Regional and Global Left Ventricular Myocardial Function Using Strain and Strain-rate Imaging in Patients with Metabolic Syndrome

Ambulatory arterial stiffness index is associated with impaired left atrial mechanical functions in hypertensive diabetic patients: A speckle tracking study

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