Abstract 359: Left Ventricular Strain and Strain Rate Imaging in Asymptomatic Patients With Type 2 Diabetes Mellitus
Background: Regional left ventricular (LV) myocardial functional changes in early diabetic cardiomyopathy are not well documented. LV multidirectional strain and strain rate (SR) analyses were utilized to detect subtle myocardial dysfunction in patients with truly uncomplicated type 2 diabetes mellitus (DM).
Methods: One hundred male subjects (47 with and 53 without DM) were recruited. Exclusion criteria for DM patients included HbA1c >8.5%, known cardiovascular disease or DM related complications, blood pressure >150/85 mmHg. Myocardial ischemia was excluded by a negative dobutamine stress test. Healthy controls were matched for age, body mass index and body surface area.
Results: Mean age was 57±6yrs. Median DM diagnosis duration was 4yrs, and mean HbA1c was 6.4±0.7%. There were no differences in LV end-diastolic volume index (41±9 vs 44±8mL/m2, p=ns), end-systolic volume index (16±5 vs 18±4mL/m2, p=ns) and ejection fractions (61±6 vs 60±5%, p=ns). Transmitral E/A (0.95±0.21 vs 1.12±0.32, p=0.007) and pulmonary S/D ratios (1.45±0.28 vs 1.25±0.27, p=0.001) were more impaired in diabetics. Diabetic patients had impaired longitudinal but preserved circumferential and radial functions (Table⇓). Presence of DM was an independent predictor for longitudinal strain, systolic SR and early diastolic SR on multiple linear regressions (all p<0.001).
Conclusions: LV longitudinal systolic and diastolic functions were impaired but circumferential and radial functions were preserved in uncomplicated type 2 diabetic patients.