Right Heart Mechanics in Untreated Normotensive Patients with Prediabetes and Type 2 Diabetes Mellitus: A Two- and Three-Dimensional Echocardiographic Study

Tadić, Marijana; Ćelić, Vera; Cuspidi, Cesare; Ilić, Sanja; Penčić, Biljana; Radojkovic, Jana; Ivanović, Branislava; Stanisavljević, Dejana; Kocabay, Gönenç; Marjanovic, Tamara

doi:10.1016/j.echo.2014.11.017

Cited by 54 publications

(51 citation statements)

References 29 publications

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“…In our study, we demonstrate equal reductions of RVS free wall as well as of RVS Avg in early impaired diastolic function, with RVS Avg showing markedly lower strain, compared to RVS free wall. Our results are in line with previous data describing lower RVS Avg in normal subjects and patients with (pre‐)diabetes, compared to RVS free wall measurements.…”

Section: Discussionsupporting

confidence: 93%

“…Our results demonstrate that, beyond impaired systolic LA and LV deformation, which is already well characterized in DD and HFpEF longitudinal RA and RV mechanics are impaired early in the course of DD, as well. Our results are supported by previous studies that found reductions of longitudinal RV strain in other subclinical conditions as high‐normal blood pressure and prediabetes …”

Section: Discussionsupporting

confidence: 92%

“…To our knowledge, these changes of RV structure in early DD have not been described so far. Tadic et al reported similar data in patients with impaired glucose metabolism; they found a gradual decrease in RV end‐diastolic volume in prediabetic and diabetic patients, compared to healthy subjects, a finding that is supported by a study focusing on CMR‐based assessment of RV volumes in diabetic cardiomyopathy . Reductions of RV area and volume in preclinical cardiovascular conditions such as prediabetes and impaired diastolic function might fit into the concept of a general cardiac remodeling due to risk factors and may suggest underlying reduced compliance/elasticity of the thin‐walled RV.…”

Section: Discussionmentioning

confidence: 72%

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Right heart function in impaired left ventricular diastolic function: 2D speckle tracking echocardiography–based and Doppler tissue imaging–based analysis of right atrial and ventricular function

et al. 2017

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Aim:The aim of our study was to describe right atrial (RA) and right ventricular (RV) function, assessed by Doppler tissue imaging and 2D speckle tracking echocardiography (2DSTE), in women with signs of early impaired left ventricular diastolic function (DD). Methods and Results:In a cross-sectional trial, standard parameters of diastolic and right heart function were investigated in 438 women of the Berlin Female Risk Evaluation (BEFRI) study. In a subset of women, average peak systolic RA strain (RAS), as well as the average peak systolic RV strain of the free wall (RVS free wall) and of all RV segments (average RV strain; RVS Avg), was analyzed using 2DSTE. Compared to women with normal diastolic function (DD0), RAS, RVS free wall and RVS Avg were significantly reduced in DD (43.1% ± 11.9%, −26.7% ± 5.6%, and −23.3% ± 3.5% in DD0; vs 35.1% ± 10.4%, −23.9% ± 5.5%, and −20.6% ± 3.8% in DD; P < .01). Peak RV myocardial velocity (RV-IVV) and acceleration during isovolumetric contraction (RV-IVA) were markedly higher in DD (15.0 ± 3.9 cm/s and 3.1 ± 1.0 m/s² in DD vs 11.9 ± 3.2 cm/s and 2.8 ± 0.8 m/s² in DD0; P < .05). RAS and RV-IVV were significantly associated with DD after adjustment to age, BMI, and left atrial strain in multivariate regression analysis. Conclusion:Systolic right heart function is significantly altered in DD. DTI as well as 2DSTE constitute sensitive echocardiographic tools that enable the diagnosis of impaired right heart mechanics in early-staged DD. K E Y W O R D SDoppler tissue imaging, impaired diastolic function, myocardial strain, right atrial function, right ventricular function, 2D speckle tracking echocardiography

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 72%

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Right heart function in impaired left ventricular diastolic function: 2D speckle tracking echocardiography–based and Doppler tissue imaging–based analysis of right atrial and ventricular function

et al. 2017

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“…While exercise abnormalities have been reported in adolescents and adults with T2D, it remains unknown whether the underlying mechanisms are cardiac and/or peripheral in origin. Myocardial mechanics are altered in adults with T2D, with decreased longitudinal strain (LS) from subendocardial fibrosis reportedly occurring early in the disease process, and abnormalities in circumferential strain (CS), suggesting midwall fiber damage, thought to be a later finding . The limited data available on adolescents with T2D suggest that cardiac target organ damage can be detected early on in the course of the disease .…”

Section: Introductionmentioning

confidence: 99%

Cardiopulmonary Dysfunction and Adiponectin in Adolescents With Type 2 Diabetes

Bjornstad

Truong

Dorosz

et al. 2016

JAHA

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Background--Myocardial mechanics are altered in adults with obesity and type 2 diabetes (T2D); insulin resistance and adipokines have been implicated as important risk factors for cardiovascular disease, but these relationships are poorly described in adolescents. We hypothesized that obese adolescents and adolescents with T2D would have abnormal cardiac function compared to lean adolescents. In addition, we hypothesized that insulin sensitivity (IS), adiposity, and adipokines would be associated with altered cardiac strain and cardiopulmonary fitness in adolescents with T2D.

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“…In a Serbian/Italian study, two-dimensional and three-dimensional echocardiographic measures of right ventricle and right atrial function were decreased in normotensive patients with diabetes (without heart failure) compared with healthy controls 76. An analysis of the Pioglitazone Influence on tRiglyceride Accumulation in the Myocardium In Diabetes (PIRAMID) trial identified reduced right ventricular systolic and diastolic function by cardiac MRI in patients with uncomplicated type 2 diabetes compared with healthy controls 77…”

Section: Pathophysiologymentioning

confidence: 99%