Longitudinal Myocardial Strain Alteration Is Associated with Left Ventricular Remodeling in Asymptomatic Patients with Type 2 Diabetes Mellitus

详细信息    查看全文

• 作者：Laura Ernande ; MD ; PhD^a ; ^b ; Cyrille Bergerot ; MD^a ; Nicolas Girerd ; MD^c ; Hé ; lè ; ne Thibault ; MD ; PhD^a ; ^d ; Einar Skulstad Davidsen ; MD^e ; Pierre Gautier Pignon-Blanc ; MD^a ; Camille Amaz ; MsC^a ; Pierre Croisille ; MD ; PhD^f ; Marc L. De Buyzere ; PhD^g ; Ernst R. Rietzschel ; MD ; PhD^g ; Thierry C. Gillebert ; MD ; PhD^g ; Philippe Moulin ; MD ; PhD^d ; ^h ; Mikhael Altman ; MD^b ; Geneviè ; ve Derumeaux ; MD ; PhD^a ; ^b ; ^{gderumeaux@gmail.com" class="auth_mail}
• 关键词：Left ventricular remodeling ; Myocardial strain ; Diabetes mellitus
• 刊名：Journal of the American Society of Echocardiography
• 出版年：May 2014
• 年：2014
• 卷：27
• 期：5
• 页码：479-488
• 全文大小：1231 K

文摘

In normal subjects, left ventricular (LV) dimensions have been shown to decrease over time, while wall thickness is increasing. The aim of this study was to investigate LV remodeling in a cohort of patients with type 2 diabetes mellitus during a 3-year follow-up period and its potential association with decreased longitudinal systolic strain (蔚_L).

Methods

One hundred seventy-two patients with type 2 diabetes without overt heart disease were prospectively enrolled and underwent echocardiography with speckle-tracking imaging to assess global LV 蔚_L at baseline and at 3 years. The associations between alteration in 蔚_L (defined as |蔚_L| < 18%), LV geometry at baseline, and LV remodeling over time were evaluated.

Results

Among the 172 enrolled patients, 154 completed 3-year follow-up. At baseline, patients with 蔚_L alteration had higher LV end-systolic volumes (28 ± 11 vs 23 ± 9 mL, P < .001) and relative wall thicknesses (RWT; 0.44 ± 0.06 vs 0.40 ± 0.07, P = .008) compared with those with normal 蔚_L. At 3-year follow-up, RWTs remained stable in both groups. LV volumes significantly decreased in patients with normal 蔚_L but not in patients with 蔚_L alteration. Multivariate analysis showed that 蔚_L alteration was independently associated with LV end-systolic volume (尾 = 5.0, P = .006) and RWT (尾 = 0.03, P = .03) at baseline and with changes in both LV end-diastolic volume (尾 = 19.1, P = .001) and LV end-systolic volume (尾 = 2.6, P = .047) over 3 years.

Conclusions

In patients with type 2 diabetes, 蔚_L alteration was associated with higher RWT and LV volumes and with the absence of decreases in LV volumes over time, which might be an early sign of adverse LV remodeling.