Abstract 13187: Abnormalities in Cardiac Strain are Found in Young Adults with Type 2 Diabetes Mellitus
Introduction: Diabetic cardiomyopathy in adults begins with diastolic dysfunction progressing to systolic dysfunction and heart failure. Tissue Doppler imaging to measure strain and strain rate may demonstrate abnormalities earlier in the process than traditional echo. We hypothesized that abnormal strain can be found in young adults with Type II Diabetes Mellitus (T2DM).
Methods: Comprehensive echocardiography and speckle-tracking imaging was measured in 338 subjects (22.2 + 3.7 years, 38% male, 63% African American) stratified into lean (L=112), obese (O=121) and T2DM (T=105) groups. Anthropometrics, BP, HR, fasting lipids, glucose and CRP were collected. Echocardiograms were performed on a GE Vivid 7 machine and read with EchoPAC®software for global longitudinal (4-chamber) strain (GS) and strain rate in systole (GSRs), early diastole (GSRe) and active diastolic phase (GSRa). ANOVA was performed to compare differences among groups for CV risk factors and strain measures and ANCOVA to determine if presence of T2DM remained an independent predictor of strain after correction for risk factors (full model=age, sex, race, group (L,O,T), MAP, HR and lab values).
Results: Lean subjects were lighter with lower BP, lipids, CRP and glucose. Lean subjects had superior cardiac function with more negative GS and GSRs and more positive GSRe than O & T (p<0.001). There was no group difference in GSRa. Major determinants of global strain were sex, adiposity and MAP with age, HR, HDL contributing for GS, HDL and T2DM for GSRse and HDL & glucose for GSRa (R2: GS=0.38, GSRs=0.24, GSRe=0.41, GSRa=0.13). Presence of T2DM remained an independent predictor of GSRe even after correction for CV risk factors.
Conclusions: Obesity and BP influence strain in young adults. Presence of T2DM is associated with early diastolic strain abnormalities beyond that predicted by CV risk factors alone. Control of obesity and T2DM is needed in young adults to prevent the risk of future heart failure.
Author Disclosures: N.L. Madsen: None. P.R. Khoury: None. Z. Gao: None. S.N. Stewart: None. L. Longshore: None. A. Shah: None. L.M. Dolan: Research Grant; Modest; R01 HL105591-01 (Urbina). T.R. Kimball: Research Grant; Modest; R01 HL105591-01 (Urbina). E.M. Urbina: Research Grant; Significant; R01 HL105591-01 (Urbina).
- © 2014 by American Heart Association, Inc.