Right Ventricular Function Measures as Biomarkers of Diabetic Cardiomyopathy

Time to assess the effects of sodium–glucose co‐transporter‐2 inhibitors on the ‘forgotten' right ventricle?

“…This close relationship has also been confirmed in patients with concomitant T2DM and heart failure with preserved ejection fraction (HFpEF), in whom T2DM is associated with significant increase in the odds for right ventricular systolic and diastolic dysfunction, independently of right ventricular afterload . Mechanisms implicated into right ventricular involvement in T2DM are metabolic (hyperglycaemia, hyperlipidaemia, and hyperinsulinaemia), inflammatory, mechanistic (left ventricular involvement), and epigenetic, constituting right ventricular dysfunction a potential marker of diabetic cardiomyopathy …”

“…5 Mechanisms implicated into right ventricular involvement in T2DM are metabolic (hyperglycaemia, hyperlipidaemia, and hyperinsulinaemia), inflammatory, mechanistic (left ventricular involvement), and epigenetic, constituting right ventricular dysfunction a potential marker of diabetic cardiomyopathy. 6 Based on the established knowledge that right ventricular dysfunction is strongly associated with the corresponding risks for heart failure hospitalization and all-cause mortality in patients with HFpEF 7 and for cardiovascular and all-cause mortality in patients with heart failure with reduced ejection fraction (HFrEF), 8 it is deduced that the meticulous assessment of right ventricular function in patients with T2DM-especially in those with known atherosclerotic cardiovascular disease-might be of critical importance. At the same time, right ventricular function also appears as a promising treatment target.…”

Markers of Atrial Myopathy: Widening the Echocardiographic Window for Early Detection of Myocardial Disease

“…In addition to these, LA pressure, LA volume, its systolic strain, and stiffness would give further insights as well . In addition, detection of abnormal right ventricular mechanics may be useful as well as it may reflect the effects of pulmonary hypertension and changes in right ventricular myocardial function which may correlate with LV myocardial disease in many of the systemic disorders that may affect the heart . These would be valuable not only for the detection of early myocardial disease or dysfunction, but also to target these patients for early therapy before clinical heart failure develops.…”

“…3,4 In addition, detection of abnormal right ventricular mechanics may be useful as well as it may reflect the effects of pulmonary hypertension and changes in right ventricular myocardial function which may correlate with LV myocardial disease in many of the systemic disorders that may affect the heart. 5 These would be valuable not only for the detection of early myocardial disease or dysfunction, but also to target these patients for early therapy before clinical heart failure develops. They will also help evaluate the efficacy of various therapeutic measures designed to retard progression of early myocardial disease.…”