Abstract 8927: Subclinical LV Systolic and Diastolic Dysfunction in Uncomplicated Patients With Impaired Glucose Tolerance and Type 2 Diabetes Mellitus: Findings From 2-dimensional Speckle Tracking Echocardiography
Background: Longstanding diabetes mellitus (DM) affects left ventricular (LV) dysfunction regardless of hypertension and coronary artery disease (CAD). However, regional LV dysfunction in a group of uncomplicated and normotensive patients with impaired glucose tolerance (IGT) or DM has not been well documented.
Methods: Study population consisted of 100 patients with normal LV ejection fraction who underwent 2-dimensional speckle tracking echocardiography (2DST) and cardiac computed tomography (CT). Mean values of global longitudinal and circumferential strain profiles were determined from 2DST analyses. IGT or DM was determined in all patients by oral glucose tolerance test. The exclusion criteria included known DM, HbA1c > 8.5%, blood pressure of > 150/85 mm Hg, and diabetes-related complications (proliferative retinopathy, autonomic neuropathy, and microalbuminuria). The presence of significant CAD was also excluded by negative findings on cardiac CT. In addition, plain abdominal CT scans were performed to measure the subcutaneous and visceral adipose tissue area.
Results: A total of 57 patients (normal glucose tolerance, n = 30; IGT, n = 14; DM, n = 13) were analyzed. No significant differences were found in the LV ejection fraction whereas the transmitral and pulmonary vein flow profiles were impaired in the DM group. Interestingly, the IGT and DM groups showed reduced longitudinal systolic and diastolic function (strain, −18.0 ± 0.5 vs −16.0 ± 0.7 vs −14.6 ± 2.7 %; systolic strain rate, −1.43 ± 0.10 vs −1.17 ± 0.12 vs −0.92 ± 0.14 1/s; early diastolic strain rate, 1.33 ± 0.11 vs 1.05 ± 0.07 vs 0.89 ± 0.12 1/s; all p < 0.001). However, the circumferential function was preserved in all groups. Multiple linear regression analysis revealed that the presence of IGT or DM was an independent predictor for the LV longitudinal function (Table).
Conclusion: The LV longitudinal systolic and diastolic functions were impaired in early stages of glucose tolerance disorder.
- © 2010 by American Heart Association, Inc.