Myocardial dysfunction identified by three-dimensional speckle tracking echocardiography in type 2 diabetes patients relates to complications of microangiopathy

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• 作者：Mami Enomoto ; MD^a ; Tomoko Ishizu ; MD ; PhD ; FJCC^a ; ^b ; ^{tomoco@md.tsukuba.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Yoshihiro Seo ; MD ; PhD ; FJCC^a ; Yuri Kameda ; BSc^c ; Hiroaki Suzuki ; MD ; PhD^d ; Hiroshi Shimano ; MD ; PhD^d ; Yasushi Kawakami ; MD ; PhD^a ; ^b ; Kazutaka Aonuma ; MD ; PhD ; FJCC^a
• 关键词：Diabetic cardiomyopathy ; Three-dimensional echocardiography ; Myocardial strain
• 刊名：Journal of Cardiology
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：68
• 期：4
• 页码：282-287
• 全文大小：609 K

文摘

The clinical effect of diabetic microangiopathy on left ventricular (LV) function is still uncertain. The purpose of this study was to assess the relation between diabetic microvascular complications and comprehensive myocardial deformation measurements using three-dimensional (3D) speckle tracking echocardiography.

Methods

Seventy-seven asymptomatic patients with type 2 diabetes mellitus (DM) and 35 age-matched healthy control subjects underwent 3D echocardiography. Patients with coronary artery disease or LV ejection fraction <50% were excluded. Presence of proliferative retinopathy, microalbuminuria as nephropathy, and decreased coefficient of variation of R-R intervals (CVRR) <3% as cardiac autonomic neuropathy were defined as diabetic microvascular complications.

Results

LV ejection fraction, LV mass index, and global radial strain did not differ between control and DM patients. However, global longitudinal and circumferential strain and endocardial area change ratio were lower in patients with DM than in the controls (−12.0 ± 3.0% vs. −16.2 ± 1.9%, −27.7 ± 7.1% vs. 32.2 ± 5.7%, −37.6 ± 7.6% vs. 44.0 ± 6.2%, respectively, p < 0.001). In DM patients, longitudinal strain is related to CVRR (R = 0.58, p < 0.001), retinopathy stage, and nephropathy stage.

Conclusions

Diabetic microangiopathy and its accumulated effects significantly related to subclinical LV dysfunction are characterized by impaired longitudinal shortening.