Value of peak strain dispersion in discovering left ventricular dysfunction in diabetes mellitus

Abstract

Cardiovascular disease is one of the main causes of death in diabetes mellitus (DM) patients. The aim of the current study was to explore the value of peak strain dispersion (PSD) for discovering early-stage left ventricular (LV) dysfunction in type 2 diabetes mellitus (T2DM) patients. One hundred and one T2DM patients and sixty healthy subjects were selected for this study. T2DM patients were further divided into controlled blood glucose (HbA1c < 7%, n = 46) and uncontrolled blood glucose (HbA1c ≥ 7%, n = 55) subgroups. All participants underwent conventional echocardiography and two-dimensional speckle-tracking echocardiography. Our results showed that an obvious difference was not observed in global longitudinal strain (GLS) between the controlled blood glucose group and the control group (− 20.34% vs − 21.22%, P = 0.068). Compared with the healthy controls, the uncontrolled blood glucose group showed an impaired GLS (− 18.62% vs − 21.22%, P < 0.001). Nevertheless, PSD was appreciably increased in the controlled blood glucose group (36.02 ms vs 32.48 ms, P = 0.01) and uncontrolled blood glucose group (57.51 ms vs 32.48 ms, P < 0.001). Multivariate linear regression analysis showed that HbA1c was closely related to PSD lesion in the LV in the T2DM group (β = 0.520, P < 0.001). PSD plays an important role in evaluating the coordination and synchronization of myocardial movement and provides a more accurate and sensitive index assessment of early LV systolic function in T2DM patients. In addition, HbA1c levels were related to LV dysfunction.

Hemodynamic Effects of Permanent His Bundle Pacing Compared to Right Ventricular Pacing Assessed by Two-Dimensional Speckle-Tracking Echocardiography

“…The stimulation mode influenced not only electrical but also mechanical synchrony, as evidenced by the peak systolic dispersion (PSD) measurements obtained using 2D STE. PSD adequately reflects the degree of mechanical dyssynchrony accompanying electrotherapy [ 16 ] and is used to assess left ventricular dysfunction in other pathologies as well [ 17 , 18 ]. Our PSD results are consistent with our findings for QRSd.…”

Speckle tracking imaging combined with myocardial comprehensive index to evaluate left ventricular function changes in patients with systemic lupus erythematosus

“…PSD is the standard deviation of the peak time of the longitudinal strain in 17 segments of the left ventricle. 15 There was a statistically significantly increase in PSD in the mild-to-moderate and severe groups compared to the control group, indicating that the dispersion of myocardial mechanical motion is increased, that is, myocardial systolic synchronization is worse. 16 It has been suggested that the deposition of SLE-associated immune complexes in the cardiovascular system may lead to degeneration of cardiomyocytes and myocardial sympathetic nerves, which directly leads to the damage of the normal function of cardiomyocytes and the dysfunction of nerve fibers in the myocardial layer; this, in turn, has a serious impact on myocardial synchronous movement.…”

“…PSD is the standard deviation of the peak time of the longitudinal strain in 17 segments of the left ventricle 15 . There was a statistically significantly increase in PSD in the mild‐to‐moderate and severe groups compared to the control group, indicating that the dispersion of myocardial mechanical motion is increased, that is, myocardial systolic synchronization is worse 16 .…”

Role of Strain in the Early Diagnosis of Diabetic Cardiomyopathy

“…Em um estudo, 25 o grupo controle era constituído de hipertensos sem diabetes. Alguns Diferentes avaliações também foram estudadas nessa população, como: índice de trabalho miocárdico, 26,27 torsão miocárdica por speckle tracking, 28 disfunção sistólica do ventrículo direito por speckle tracking, 29 função cardíaca durante atividade física e capacidade ao exercício, 24,30,31 valor de dispersão entre picos sistólicos do strain, 32 efeito da frequência cardíaca, 7 função cardíaca durante ecocardiografia por estresse com dobutamina, 33 variabilidade da frequência cardíaca, 23 progressão da disfunção diastólica 34 e análise multilayer por speckle tracking. 17,23 As características ecocardiográficas de interesse para esta revisão estão apresentadas nas tabelas 3 e 4.…”

“…Em relação especificamente ao controle glicêmico, Lind et al, em estudo com 20.985 indivíduos com DM1, concluíram que, mesmo após o ajuste de outros fatores de risco cardiovascular, o risco de insuficiência cardíaca ainda foi quatro vezes maior em pacientes com mau controle glicêmico comparados aos com ótimo controle glicêmico, e cada 1% de aumento na HbA1c correspondeu a um aumento de 30% no risco de desenvolver insuficiência cardíaca. 40 Li et al exploraram a relação entre controle glicêmico e disfunção ventricular esquerda em indivíduos com DM2 por meio do valor de HbA1c; 32 não houve diferença na FEVE, entretanto, havia diferença entre o índice de massa ventricular e a velocidade de onda E mitral entre os grupos com DM versus controle, sendo maior a diferença no grupo com pior controle glicêmico. Além disso, não se observou diferença do SGL entre o grupo com bom controle glicêmico e o grupo controle.…”