Abstract 13705: Quantification of the Left Ventricular Systolic Dysfunction in Diabetic Patients with Uncontrolled Blood Glucose: A 4D Strain Based Study

Abstract

Objectives: The novel four-dimensional (4D) strain echo modality has been suggested to measure the left ventricular (LV) deformation accurately. Therefore, this study aimed to investigate the value of 4D strain in detecting subclinical LV dysfunction caused by diabetes mellitus (DM).

Methods: We studied 68 patients with DM and normal LV ejection fraction (LVEF), as well as 63 age-matched controls. Patients with coronary artery disease, valvular disease, and other structural heart diseases were excluded. DM patients were further divided into 2 groups according to the HbA_1c level: DM1 (n=31, HbA1c<7%), DM2 (n=37, HbA1c≥7%). All patients underwent conventional echocardiography and 4D Auto LV volume quantification (Vivid E9 , GE Ultrasound System). The global longitudinal strain (GLS), circumferential strain (GCS), area strain (GAS) and radial strain (GRS) were analyzed and compared among groups.

Results: As shown in Table 1, no statistical differences were found in baseline characteristics among groups. The diabetic patients showed decreased systolic function compared with controls, evidenced by lower GLS (p<0.001), GCS (p=0.009), GAS (p=0.001) and GRS (p=0.001). Sub-group analysis showed that GLS was compromised in both DM1 (p=0.038) and DM2 (p<0.001) groups when compared with controls. However, the impairment of GCS, GAS and GRS were only observed in DM2 (all p<0.001) but not in DM1. In addition, all the parameters of LV systolic function were even lower in DM2 than in DM1 group (all <0.05).

Conclusions: The current study demonstrated that the GLS by 4D strain could be a sensitive indicator of an early LV systolic dysfunction in asymptomatic diabetic patients. The LV dysfunction was further deteriorated if the blood glucose level poorly controlled.