Early detection of diabetic cardiomyopathy: usefulness of tissue Doppler imaging

Bonito, Procolo Di; Moio, Nicola; Cavuto, Luigi; Covino, Gregorio; Murena, Ernesto; Scilla, Carolina; Turco, Salvatore; Capaldo, Brunella; Sibilio, Girolamo

doi:10.1111/j.1464-5491.2005.01685.x

Cited by 121 publications

(84 citation statements)

References 33 publications

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“…However, 2-dimensional longitudinal strain showed that the patients had abnormal systolic function presented by significantly lower LV global peak systolic strain compared to that of controls. These results are consistent with other studies which have demonstrated that tissue Doppler and 2-dimensional longitudinal strain have the potential for detecting subclinical diastolic and systolic dysfunction in the asymptomatic diabetic population [16][17][18].…”

Section: Discussionsupporting

confidence: 93%

Alpha-Lipoic Acid Improves Subclinical Left Ventricular Dysfunction in Asymptomatic Patients with Type 1 Diabetes

Hegazy¹,

Tolba²,

Mostafa³

et al. 2013

Rev Diabet Stud

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■ Abstract BACKGROUND:Oxidative stress plays an important role in the development of diabetic cardiomyopathy. Alpha-lipoic acid (ALA) is a powerful antioxidant that may have a protective role in diabetic cardiac dysfunction. AIM: We investigated the possible beneficial effect of alpha-lipoic acid on diabetic left ventricular (LV) dysfunction in children and adolescents with asymptomatic type 1 diabetes (T1D). SUB-JECTS AND METHODS: Thirty T1D patients (aged 10-14) were randomized to receive insulin treatment (n = 15) or insulin plus alpha-lipoic acid 300 mg twice daily (n = 15) for four months. Age and sex matched healthy controls (n = 15) were also included. Patients were evaluated with conventional 2-dimensional echocardiographic examination (2D), pulsed tissue Doppler (PTD), and 2-dimensional longitudinal strain echocardiography (2DS) before and after therapy. Glutathione, malondialdhyde (MDA), nitric oxide (NO), tumor necrosis factor-alpha (TNF-alpha), Fas ligand (Fas-L), matrix metalloproteinase 2 (MMP-2), and troponin-I were determined and correlated to echocardiographic parameters. RESULTS: Diabetic patients had significantly lower levels of glutathione and significantly higher MDA, NO, TNF-alpha, Fas-L, MMP-2, and troponin-I levels than control subjects. The expression of transforming growth factor beta (TGF-beta) mRNA in peripheral blood mononuclear cells was also increased in diabetic patients. Significant correlations of mitral e'/a' ratio and left ventricular global peak systolic strain with glutathione, MDA, NO, TNF-alpha, and Fas-L were observed in diabetic patients. Alpha-lipoic acid significantly increased glutathione level and significantly decreased MDA, NO, TNF-alpha, Fas-L, MMP-2, troponin-I levels, and TGF-beta gene expression. Moreover, alphalipoic acid significantly increased mitral e'/a' ratio and left ventricular global peak systolic strain in diabetic patients. CONCLUSION: These findings suggest that alpha-lipoic acid may have a role in preventing the development of diabetic cardiomyopathy in type 1 diabetes.

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Section: Discussionsupporting

confidence: 93%

Alpha-Lipoic Acid Improves Subclinical Left Ventricular Dysfunction in Asymptomatic Patients with Type 1 Diabetes

Hegazy¹,

Tolba²,

Mostafa³

et al. 2013

Rev Diabet Stud

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“…We recently demonstrated that diabetes was associated with remarkably reduced early diastolic (e 0 ) and a slightly reduced peak systolic (S 0 ) longitudinal tissue velocity among patients without CAD, with no detectable influence on conventional echocardiography parameters (11). Other studies have found similar results (12)(13)(14)(15).…”

Section: Introductionmentioning

confidence: 68%

Metformin is associated with improved left ventricular diastolic function measured by tissue Doppler imaging in patients with diabetes

Andersson

Søgaard²,

Hoffmann³

et al. 2010

European Journal of Endocrinology

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Objective: To examine the association between selected glucose-lowering medications and left ventricular (LV) diastolic function in patients with diabetes. Design: Retrospective cohort study (years 2005-2008). Methods: Echocardiograms of 242 patients with diabetes undergoing coronary angiography were analyzed. All patients had an LV ejection fraction (LVEF) R20% and were without atrial fibrillation, bundle branch block, valvular disease, or cardiac pacemaker. Patients were grouped according to the use of metformin (nZ56), sulfonylureas (nZ43), insulin (nZ61), and combination treatment (nZ82). Results: Mean age (66G10 years) and mean LVEF (45G11%) were similar across the groups. Mean isovolumic relaxation time (IVRT) was 66G31, 79G42, 69G23, and 66G29 ms in metformin, sulfonylureas, insulin, and combination treatment groups respectively (PZ0.4). Mean early diastolic longitudinal tissue velocity (e 0 ) was 5.3G1.6, 4.6G1.6, 5.3G1.8, and 5.4G1.7 cm/s in metformin, sulfonylureas, insulin, and combination treatment groups (PZ0.04). In adjusted linear regression models, the use of metformin was associated with a shorter IVRT (parameter estimate K9.9 ms, PZ0.049) and higher e 0 (parameter estimate C0.52 cm/s, PZ0.03), compared with no use of metformin. The effects of metformin were not altered by concomitant use of sulfonylureas or insulin (P for interactions O0.4). Conclusions: The use of metformin is associated with improved LV relaxation, as compared with no use of metformin.

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“…В связи с этим соотношение Е/е и ДЗЛК могут использоваться для объективного определения тя-жести ДД ЛЖ и последующего наблюдения пациен-тов по мере прогрессирования нарушений ДФ при СД [19]. Как показывают клинические наблюдения, именно выраженность ДД, а не ФВ ЛЖ, коррелиру-ет с тяжестью ХСН.…”

Section: Discussionunclassified

Isolated left ventricular diastolic dysfunction in diabetes mellitus: opinions change

Kukharenko

Семеновна²,

Yadrikhinskaya

et al. 2017

Probl Endokrinol (Mosk)

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Aim — to compare the features of diastolic dysfunction (DD) with preserved left ventricular (LV) ejection fraction (EF) in patients with diabetes mellitus type 2 (DM2) with arterial hypertension (AH) and in patients with essential hypertension (EH) without diabetes.Material and methods. The study involved 87 patients with DD with preserved LV EF: 53 patients with DM2 with AH and 34 patients EH without diabetes. Transthoracic echocardiography was performed by ultrasonic imaging system iE33 xMATRIX («Philips», USA). DD was determined in a complex: type on the basis of the ratio parameters of pulsed-wave (E/A) and tissue (e/a) Doppler; and severity on the Е/e values and pulmonary capillary wedge pressure (PCWP). Myocardial contractile function was assessed by traditional LVEF by Simpson and more exactly, in details on the basis of the longitudinal, radial and circular deformation of the LV myocardium by speckle-tracking echocardiography (using the program Q-lab 3.0 Advanced Ultrasound Quantification software).Results. The groups were comparable in clinical characteristics. The average level of HbA1c in patients with DM2 was 8.2±1.7%. The average LV EF by Simpson in the EH group was 59.9±8.1, in DM2 — 58.3±6.7 (p=0.228). There were more severe disorders of LV Diastolic function in DM2 patients: the values of E/e (p=0.000) and PCWP (p=0.001) were significantly higher in diabetic patients (14,1±5,5 and 15,3±4,7 mm Hg) than in EH (9.7±2.3 and 11.9±1.3 mm Hg). Although that the LV EF (by traditional echocardiographic method of Simpson) was preserved in both groups , the LV global longitudinal strain (12.4±3.0) was significantly lower in DM2 (p=0.005), than patients with EH (16.6±2.0) by speckle-tracking echocardiography.Conclusion. Severity of LV DD are harder in Patients with diabetes and hypertension, than in patients with EH with the similarity of clinical manifestations and data of traditional echocardiographic methods. There were found initial disorders of LV longitudinal myocardial fibers contraction by speckle-tracking echocardiography in patients with DM and preserved LV EF. The combination of impairment of systolic and diastolic function in diabetes is inseparable. Early development of combined systolic and diastolic dysfunction in DM2 is associated with a poor prognosis: a higher risk of early development of atrial fibrillation, ventricular arrhythmias and progressive heart failure.

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Early detection of diabetic cardiomyopathy: usefulness of tissue Doppler imaging

Abstract: An early stage of diabetic cardiomyopathy can be evidenced by TDI in Type 2 diabetic subjects even in the presence of a normal cardiac function with CE. This abnormality is associated with insulin resistance.

Cited by 121 publications

References 33 publications

Alpha-Lipoic Acid Improves Subclinical Left Ventricular Dysfunction in Asymptomatic Patients with Type 1 Diabetes

Alpha-Lipoic Acid Improves Subclinical Left Ventricular Dysfunction in Asymptomatic Patients with Type 1 Diabetes

Metformin is associated with improved left ventricular diastolic function measured by tissue Doppler imaging in patients with diabetes

Isolated left ventricular diastolic dysfunction in diabetes mellitus: opinions change

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