Assessment of the left ventricular function in normotensive prediabetics: a tissue Doppler echocardiography study

Abstract

Objective: Several studies have shown that left ventricular (LV) dysfunction is increased in individuals with diabetes. However, there are scarce data about LV function in prediabetics. This study assessed the early changes in LV diastolic and systolic myocardial function in normotensive prediabetics using tissue Doppler echocardiography (TDE). Subjects and methods: We evaluated 94 patients with prediabetes (mean age of 50.8 ± 6.9 years, 78 female) without known cardiovascular diseases and 70 healthy volunteers with similar demographic characteristics. Systolic and diastolic function of the left ventricle was evaluated with transthoracic echocardiography according to the latest consensus recommendations including TDE. Results: The mean results of septal and lateral parts of the mitral annulus Pulsed wave TDE showed that myocardial systolic wave (Sm), myocardial early diastolic wave (Em) and Em to atrial peak velocity (Am) ratio were significantly lower whereas early diastolic peak flow velocity (E) to Em ratio, myocardial isovolumetric relaxation time (IVRTm), myocardial isovolumetric contraction time (IVCTm) and myocardial performance index (MPI) values were significantly higher in patients with prediabetes (preDM). In addition, mean left atrium (LA) diameter measured with M-mode echocardiography was significantly higher in prediabetics than controls. Conclusion: PreDM is associated with subclinical LV systolic and diastolic dysfunction as evaluated by TDE. Arch Endocrinol Metab. 2016;60(4):341-7

Study of Myocardial Performance Index in Prediabetes and Its Correlation with Other Cardiovascular Risk Factors

“…(8) We have also found that total cholesterol, triglycerides, LDL and VLDL were significantly higher in prediabetes and high density lipoprotein were significantly lower in prediabetes as compared to controls (p=0.0001). Same observation was seen by Murat Akçay et al (8) Myocardial performance index in cases was higher than controls. Difference in MPI in cases and controls was found to be statistically significant.…”

“…(p<0.05, S) Similarly, Murat Akçay et al reported BMI was statistically higher in prediabetes in comparison to age and sex matched controls. (8) In our study waist hip ratio was higher in prediabetes when compared to age and sex matched controls. However, Murat Akçay et al reported that mean waist hip ratio for cases and controls were almost similar.…”

Left and right ventricular function by echocardiography, tissue Doppler imaging, carotid intima-media thickness, and asymmetric dimethyl arginine levels in obese adolescents with metabolic syndrome

“…Ayalon et al 1 reported that preclinical left ventricle diastolic dysfunction could occur independently of left ventricle hypertrophy in metabolic syndrome with lower E/A ratio and mean e′. While Tadic et al 27 found non-dipping pattern and metabolic syndrome separately cause left ventricle diastolic dysfunction in hypertensive patients, Akçay et al 28 found lower E/A ratio, higher E/e′ and myocardial performance index values in normotensive prediabetics. Furthermore, Karakurt et al 26 found that adult metabolic syndrome patients with preserved left ventricle ejection fraction had low E, E/A ratio in right ventricle, and high right ventricle global myocardial performance index as compared to the control group and identified diastolic dysfunction.…”

Prediabetes, heart mechanics, and echocardiography: A narrative review

“…One study detected no difference concerning these variables between Pre‐DM subgroups and cases with DM. The available results are contradictory in that whereas some studies have found differences with respect to the aforementioned variables between some Pre‐DM subgroups and NL groups, some other investigations have reported no difference 15,17,24,25,29 . Two studies compared Pre‐DM subgroups (HbA1c < 5.7% vs HbA1c = 5.7%‐6.4%) with each other and revealed no difference regarding TDI‐based velocities 39,44 and LV longitudinal deformations 44 .…”