Speckle tracking echocardiography in hypertensive males with glucose metabolism disorders

Abstract

T ype 2 diabetes mellitus (DM) and arterial hypertension (HTN) are major medical and public health problems worldwide. The total number of people with DM will rise from 171 million in 2000 to 552 million by 2030 [1]. The number of adults with HTN is predicted to increase by 60% to a total of 1.56 billion people by 2025 [2]. HTN is present in approximately 60% of patients with type 2 DM [3]. 80% of diabetic patients die from cardiovascular complications. Both diseases affect the same major target organs. Myocardial envolvement is characterized by microvascular disease, altered metabolism and increased fi brosis that lead to gradual decline in left ventricular (LV) function. Early alterations of myocardium should be diagnosed early and treated aggressively to prevent microvascular and macrovascular morbidity and mortality.Insulin resistance (IR) is a key pathogenetic mechanism of type 2 DM and exists for many years even in normoglycemic patients. Impaired fasting glucose (IFG), or 'pre-diabetes', refl ect the natural history of progression from normoglycaemia to type 2 DM. The hypertensive patients with IR and pre-diabetes may have long-standing subclinical myocardial dysfunction before onset of DM [4]. Speckle-tracking echocardiography is a modern ultrasound technique which allows to investigate early myocardial changes in patients even without LV hypertrophy and diastolic dysfunction. Compared to standard echocardiography parameters, myocardial strain and strain rate (SR) analyses are more sensitive indices of LV function. At present, there is a lack of studies concerning the development of structural and functional myocardial abnormalities in patients with different glucose abnormalities like IR, pre-diabetes and type 2 DM.The aim of our study was to assess changes in LV function with speckle tracking echocardiography in hypertensive patients with different types of glucose metabolism abnormalities. Aim. Early left ventricle (LV) abnormalities are hardly detectable by means of standard echocardiography in patients with hypertension (HTN) and glucose metabolism disorders. The objective of this study was to assess changes in LV function with speckle tracking echocardiography in hypertensive males with different types of glucose metabolism abnormalities. Materials and methodsMethods and results. We recruited 158 hypertensive males with different glycemic status. The multidirectional LV strain was assessed by two-dimensional speckle tracking echocardiography. The patients with HTN and type 2 diabetes mellitus demonstrated signifi cant reduction of LV global longitudinal strain and early diastolic strain rate despite preserved LV ejection fraction.Conclusion. Speckle tracking echocardiography can identify subclinical myocardial alterations in hypertensive males with glucose metabolism abnormalities. Спекл-трекінг ехокардіографія в чоловіків з артеріальною гіпертензією та порушеннями метаболізму глюкози М.Ю. КолесникСтандартна ехокардіографія не має достатньої чутливості для оцінювання впливу порушень метаболізму глю...

Assessment of Left Ventricular Functions in Hypertensive Diabetic Patients by Speckle Tracking Imaging: Correlation with Brain Natriuretic Peptide Levels

“…And it is the first to decline in hypertensive diseases, as per Ikonomidis et al [30], Yu. Kolesnyk [31], and Yau-Huei Lai et al [33]. STE allows objective quantification of cardiac motion and deformation, irrespective of echo beam direction, thus providing a detailed understanding of cardiac mechanics from all aspects.…”