Abstract 14846: Development of Subclinical Myocardial Damage in Patients with Multiple Diabetic Complications
Background: Diabetic mellitus (DM) retinopathy, nephropathy, and neuropathy have been reported to have prognostic impacts on cardiovascular disease. We hypothesized that the presence of DM complications is related with subclinical left ventricular (LV) dysfunction. Accordingly, the purpose of this study was to assess the relation between DM complications and myocardial function using newly developed three-dimensional speckle tracking echocardiography (3D-STE).
Methods: We studied 93 asymptomatic type II DM patients and 15 normal controls. Patients with ischemic heart disease were excluded. Doppler echocardiographic examinations including 3D-STE were performed, and LV maximum systolic longitudinal strain (LS),radial strain(RS), and circumferential strain(CS) were measured.The presence of proliferative retinopathy, microalbuminuria, and decreased coefficient of variation of R-R intervals(CVRR)< 10% were defined as DM complications.The total number of the presence of three complications was calculated as the diabetic complication score.
Results: LV ejection fraction, LV mass index, CS, and RS did not differ between control and patients with DM. However, LS was significantly lower in patients with DM than that in the control (-16.2±1.9 vs. -12±3.0 %, p<0.001).As shown in the figure, LS was decreased with increases of the diabetic complication score. In particular, LS significantly related with CVRR. In a stepwise regression analysis, the diabetic complication score was selected as the independent determinant of LS among following variables; age, HbA1c, body mass index, and systolic blood pressure.
Conclusion: The longitudinal myocardial contraction abnormality related with the multiple involvement of DM complications, especially with cardiac autonomic dysfunction. The present study suggests that subclinical myocardial damage may be already developed in patients with mutiple DM complicatons.
- © 2011 by American Heart Association, Inc.