The Systolic and Diastolic Cardiac Function of Patients With Type 2 Diabetes Mellitus: An Evaluation of Left Ventricular Strain and Torsion Using Conventional and Speckle Tracking Echocardiography

Abstract

Objectives: This study aimed to quantify left ventricular (LV) myocardial strain and torsion in patients with type 2 diabetes mellitus (T2DM) and evaluate their systolic and diastolic function using conventional and speckle tracking echocardiography.Methods: Forty-seven patients with T2DM were divided into a group without microvascular complications (the DM A group) and a group with microvascular complications (the DM B group), while another 27 healthy participants acted as the control group. All the participants had had an echocardiography examination. All the original data were imported into EchoPAC workstation for the analysis and quantification of LV strain and torsion.Results: Compared with the control group, the LV end-diastolic volume, end-systolic volume, and ejection fraction of the DM A and DM B groups showed no significant differences, but the global longitudinal strain and the global circular strain were reduced in the DM B group. There were significant differences in the left ventricular relative wall thickness (RWT), left ventricular mass index (LVMI), the early mitral valvular blood flow velocity peak/left ventricular sidewall mitral annulus late peak velocity, left ventricular sidewall mitral annulus early peak velocity/left ventricular sidewall mitral annulus late peak velocity, isovolumic relaxation time, peak twisting, peak untwisting velocity (PUV), untwisting rate (UntwR), time peak twisting velocity (TPTV), and time peak untwisting velocity (TPUV) between the DM A, DM B, and control groups. While the peak twisting velocity (PTV) was slower in the DM B group compared with the control group, the RWT, PTV, PUV, UntwR, TPTV, and TPUV in the DM B group were significantly different from the DM A group.Conclusion: The cardiac function of patients with T2DM in its early stages, when there are no microvascular complications, could be monitored with the analysis of two-dimensional strain and torsion.

Combined with the insulin resistance index in assessing subclinical systolic function in newly diagnosed type 2 diabetes mellitus:An analysis based on automated functional imaging echocardiography

“…This model value served as the virtual probability index for the combined utilization of these ve indicators, followed by conducting ROC analysis. (3)The results of the ROC analysis demonstrated that TyG-BMI, METS-IR, IVSD, SBP, LA, and their combined application were all effective in predicting and evaluating cardiac dysfunction in individuals with diabetes. The corresponding ROC-AUC values (95% CI) for these predictors were 0.750 (0.564 ~ 0.934), 0.774 (0.582 ~ 0.944), 0.702 (0.461 ~ 0.948), 0.737 (0.478 ~ 0.983), and 0.726 (0.483 ~ 951) respectively; while the combined application of these ve indices using the Log P model exhibited the highest predictive e ciency with an ROC-AUC value of 0.878 (0.770 ~0.987).…”

“…Approximately half of individuals with diabetes ultimately succumb to cardiovascular events [2]. It has been reported that patients with diabetes may exhibit left ventricular longitudinal myocardial systolic dysfunction, particularly in the presence of early-onset coronary artery disease, valvular disease, and associated cardiovascular risk factors [3][4]. This dysfunction is considered an initial marker of subclinical central impairment in such patients [5], potentially attributed to impaired myocardial energetics metabolism and reduced ventricular systolic strain [6].…”

Effects of acromegaly treatment on left ventricular systolic function assessed by speckle tracking echocardiography in relation to sex differences: results from a prospective single center study

“…The global longitudinal strain (GLS) is a well validated, reproducible tool for the measurement of global left ventricular (LV) systolic function and provides relevant evidence on the diagnostic and prognostic implications ( 10 , 11 ). Reduction in GLS predicts worse cardiovascular outcomes ( 12 , 13 ) and evaluation of such reduction has been applied to the early detection of heart valve diseases, myocardial ischemia, hypertrophic cardiomyopathy, and cardiotoxicity during cancer therapy ( 14 ) as well as in the preclinical detection of cardiac involvement in the systemic, metabolic and endocrine diseases ( 13 , 15 – 17 ). To date, there have been only a few studies evaluating LV function using STE in patients with active acromegaly and preserved EF ( 8 , 18 – 20 ).…”

Assessment of left ventricular function in patients with type 2 diabetes mellitus by non-invasive myocardial work

“…First, the potential confounding effects of other coexisting conditions, including but not limited to hyperlipidemia and hypertension, on cardiac function injury have not been adequately addressed. Second, conventional ultrasound parameters have not been comprehensively evaluated in comparative studies (8)(9)(10). Finally, the results of some studies are controversial.…”