Left ventricular systolic dyssynchrony: a novel imaging marker for early assessment of myocardial damage in Chinese type 2 diabetes mellitus patients with normal left ventricular ejection fraction and normal myocardial perfusion

Wang, Yufeng; Yu, Wenji; Yang, Xiaoyu; Zhang, Feifei; Sun, Yongjun; Hu, Yurui; Yang, Lechen; Jiang, Qi; Wang, Jianfeng; Shao, Xiaoliang; Wang, Yuetao

doi:10.1007/s12350-023-03215-5

Cited by 4 publications

(4 citation statements)

References 39 publications

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“…Our previous study found that left ventricular systolic dyssynchrony (LVSD) was present among 21.1% of individuals with T2DM who exhibited normal LVEF and normal myocardial perfusion, which is also known as subclinical myocardial damage, and need early intervention to improve poor prognosis. Besides, we also found that overweight is closely correlated with subclinical myocardial damage ( 5 ).…”

Section: Introductionmentioning

confidence: 68%

“…Previous studies have found that overweight was independently associated with subclinical myocardial injury quantified by radionuclide MPI and 3-dimensional echocardiography ( 5 , 19 , 26 ). In addition to measuring systemic fat, we also assessed regional fat distribution by measuring EFV, which is a special visceral adipose tissue located between the myocardium around the heart and the visceral pericardium, and may be a superior marker compared to BMI.…”

Section: Discussionmentioning

confidence: 93%

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Association of epicardial fat volume with subclinical myocardial damage in patients with type 2 diabetes mellitus

Hu,

Yu,

Zhang

et al. 2024

Quant Imaging Med Surg

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Background In type 2 diabetes mellitus (T2DM) patients, left ventricular systolic dyssynchrony (LVSD) with normal left ventricular ejection fraction (LVEF) and normal myocardial perfusion could referred to as subclinical myocardial damage, which is difficult to diagnose at an early stage. Epicardial adipose tissue, a distinctive heart-specific visceral fat, is closely related to various cardiovascular diseases. The objective of this study was to investigate the correlation between epicardial fat volume (EFV) and subclinical myocardial damage in T2DM patients. Methods This retrospective cross-sectional study included 117 T2DM patients with normal myocardial perfusion by single photon emission computed tomography-computed tomography (SPECT-CT) and normal LVEF by echocardiography. The study was conducted from January 2018 to December 2022. Patient data were collected through electronic medical records including basic patient information, medical history, laboratory tests, and medication data. The EFV was quantified through a non-contrast CT scan. Quantitative indicators of LVSD including phase standard deviation (PSD) and phase histogram bandwidth (PBW) were obtained through phase analysis of the gated rest myocardial perfusion imaging (MPI). Additionally, 83 healthy individuals at the same time were selected to gain the reference threshold of LVSD indicators (13.1° for PSD and 37.6° for PBW). Univariate and multivariable logistic regression models were performed to analyze factors influencing LVSD. A generalized additive model (GAM) was applied to explore the relationship between EFV and LVSD. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of EFV for LVSD. Results Among all patients, 32 (27.4%) patients had LVSD. Compared with the non-LVSD group, the body mass index (BMI) and EFV were higher in the LVSD group (25.83±2.66 vs. 23.94±3.13 kg/m 2 ; 142.41±44.17 vs. 108.01±38.24 cm 3 , respectively, both P<0.05). Multivariate regression analysis revealed that EFV was independently associated with LVSD [odds ratio (OR) =1.19; 95% confidence interval (CI): 1.06–1.34; P=0.003]. Age, BMI, incidence of hypertension, and LVSD were increased with tertiles of EFV (all P<0.05). The GAM indicated a linear association between EFV and LVSD. The ROC curve analysis concluded that the area under the curve (AUC) of EFV for predicting subclinical myocardial damage in T2DM patients was 0.732 (95% CI: 0.633–0.831, P<0.001), with the optimal threshold of 122.26 cm 3 , sensitivity of 71.9%, and specificity of 69.4%. Conclusions EFV is an independent risk factor for LVSD in T2DM patients with normal LVEF and normal MPI, which could potentially serve as a novel imaging marker and a potential therapeutic target for subclinical myocardial damage.

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Section: Introductionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 93%

Association of epicardial fat volume with subclinical myocardial damage in patients with type 2 diabetes mellitus

Hu,

Yu,

Zhang

et al. 2024

Quant Imaging Med Surg

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“…Left ventricular systolic asynchrony can lead to ineffective ventricular pressure work, which in the long run can lead to overall left ventricular systolic dysfunction [21]. Similarly, LVSD can also be present in T2DM patients with normal LVEF and normal myocardial perfusion, and has been shown to be a novel imaging marker for early assessment of myocardial injury [14]. Therefore, LVSD can detect myocardial involvement earlier, indicating subclinical left ventricular systolic dysfunction.…”

Section: Correlation Analysis and Linear Regression Analysis Of Left ...mentioning

confidence: 99%

“…In addition to GLS, LVSD(left ventricular systolic dyssynchrony), a novel STE imaging marker, is also closely related to left ventricular systolic function. Recenstudieclearly show that they are more sensitive to detect subclinical left ventricular systolic dysfunction than LVFE [14]. However, there is no study investigate the value of STE in evaluating subclinical myocardial function injury in CS patients with different disease activity.…”

Section: Introductionmentioning

confidence: 99%

Left ventricular subclinical systolic myocardial dysfunction assessed by speckle-tracking in patients with Cushing’s syndrome

Jin,

He,

Huang

et al. 2024

Preprint

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Purpose: Two-dimensional speckle tracking echocardiography is a novel ultrasound technique, which can detect early subclinical myocardial dysfunction with high sensitivity. The purpose of this study was to explore the value of speckle tracking echocardiography in the evaluation of subclinical myocardial injury in patients with Cushing’s syndrome. Methods: 35 patients with Cushing’s syndrome and 29 healthy controls matched for age, sex, BMI, and systolic blood pressure were included in the study. All subjects was assessed using both conventional Doppler echocardiography and speckle tracking echocardiography. Among patients, they were further divided into inactive group (n=7) and active group (n=28) based on cortisol levels. Trend analysis was used among patients in different disease activity. Correlation analysis and linear regression analysis were used to explore influence factors related to subclinical myocardial dysfunction. Results: Left ventricular ejection fraction value showed no statistical difference between patients Cushing’s syndrome and control group. However, GLS and LVSD, increased significantly in Cushing’s syndrome group. Also, among active Cushing’s syndrome group, inactive Cushing’s syndrome group and control group, GLS (-15.4±3.0 vs -18.1±3.1 vs-19.4±2.4, P＜0001) and LVSD(48.9±21.5 vs 43.5±17.9 vs 28.5±8.3, P＜0001) decreased by the state of disease activity. In addition, GLS and LVSD were both linearly corrected with 24-hour urinary cortisol level. Conclusion: GLS and LVSD are sensitive parameters in detecting and monitoring subclinical myocardial systolic dysfunction in patients with Cushing’s syndrome. Myocardial injury is linearly correlated with cortisol level, which can be partially reversed after the biochemical control of cortisol.

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SPECT myocardial perfusion imaging for the evaluation of left ventricular mechanical dyssynchrony in obese patients

Caliskan,

Inanir

2024

J of Clinical Ultrasound

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ObjectiveLeft ventricular dyssynchrony (LVD), the loss of coordinated contraction in the left ventricle, is an early sign of heart failure. LVD can be assessed using phase analysis techniques with gated single‐photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI). This study aimed to investigate the impact of obesity on LVD through phase analysis.MethodsWe retrospectively enrolled 152 obese patients and 80 age‐ and sex‐matched nonobese patients who showed normal myocardial perfusion and normal left ventricular ejection fraction (LVEF) on MPI. Phase standard deviation (PSD) and phase histogram bandwidth (PBW), as phase analysis parameters, were compared between patients with and without obesity.ResultsAlthough PSD values were within the normal range (cut‐off value >23) for both groups, the PSD values of obese patients were higher than those of the nonobese (20.49 ± 8.66 vs. 14.81 ± 4.93; p < 0.05). PBW values of obese patients were statistically significantly higher than those of the nonobese (57.03 ± 23.17 vs. 41.40 ± 9.96; p < 0.05). The PBW values of obese patients exceeded the normal limits (cut‐off value >49). A weak positive correlation was observed between body mass index (BMI) and PBW values in obese patients (r = 0.181, p < 0.05). In patients of normal weight, no correlations were found between BMI and phase analysis parameters.ConclusionLVD may develop in obese patients, even when myocardial perfusion and ejection fraction are preserved. The use of phase analysis with gated SPECT could be an additional finding improving the early detection of left ventricular dyssynchrony in obese patients.

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Left ventricular systolic dyssynchrony: a novel imaging marker for early assessment of myocardial damage in Chinese type 2 diabetes mellitus patients with normal left ventricular ejection fraction and normal myocardial perfusion

Cited by 4 publications

References 39 publications

Association of epicardial fat volume with subclinical myocardial damage in patients with type 2 diabetes mellitus

Association of epicardial fat volume with subclinical myocardial damage in patients with type 2 diabetes mellitus

Left ventricular subclinical systolic myocardial dysfunction assessed by speckle-tracking in patients with Cushing’s syndrome

SPECT myocardial perfusion imaging for the evaluation of left ventricular mechanical dyssynchrony in obese patients

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