Left ventricular mechanics in untreated normotensive patients with type 2 diabetes mellitus

A two- and three-dimensional speckle tracking study

Marijana Tadic, Sanja Ilic, Cesare Cuspidi, Biljana Stojcevski, Branislava Ivanovic, Ljiljana Bukarica, Ljilja Jozika, Vera Celic

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background Our aim was to investigate left ventricular (LV) mechanics estimated by two- (2DE) and three-dimensional echocardiography (3DE) strains in subjects with type 2 diabetes mellitus (DM). Methods This cross-sectional study included 50 untreated normotensive DM subjects and 50 healthy controls similar by sex and age. All the subjects underwent adequate laboratory analyses and complete 2DE and 3DE examination. Results Left ventricular mechanics, assessed by 2DE, was impaired in all three directions. Global longitudinal 3DE strain was significantly decreased in the DM group in comparison with the controls (-17.8 ± 2.5 vs. -19.1 ± 2.7%, P = 0.014). Similar results were found for 3DE global circumferential strain (-18.9 ± 2.9 vs. -20.4 ± 3.2%, P = 0.01), 3DE global radial strain (40.3 ± 6.9 vs. 43.1 ± 7.3%, P = 0.035), and 3DE global area strain (-29.2 ± 3.7 vs. -31 ± 4%, P = 0.024). LV torsion was similar between the DM patients and the controls (2.1 ± 0.6 vs. 1.9 ± 0.5 °/cm, P = 0.073); whereas LV untwisting rate was significantly increased in the DM subjects (-114 ± 26 vs. -96 ±23 °/s, P <0.001). A multivariate analysis showed that 3DE global longitudinal and area myocardial functions were associated with HbA1c independently of 3DE LV mass index. Conclusion Left ventricular deformation obtained by 3DE is significantly impaired in the type 2 DM patients. HbA1c is independently associated with LV mechanics that implies that early anti-diabetic therapy and normalization of the fasting glucose level and HbA1c could impede further cardiac damage.

Original languageEnglish
Pages (from-to)947-955
Number of pages9
JournalEchocardiography
Volume32
Issue number6
DOIs
Publication statusPublished - Jun 1 2015

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Mechanics
Type 2 Diabetes Mellitus
Diabetes Mellitus
Three-Dimensional Echocardiography
Fasting
Healthy Volunteers
Multivariate Analysis
Cross-Sectional Studies
Glucose
Therapeutics

Keywords

  • diabetes mellitus
  • left ventricle
  • speckle tracking imaging
  • three-dimensional echocardiography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Left ventricular mechanics in untreated normotensive patients with type 2 diabetes mellitus : A two- and three-dimensional speckle tracking study. / Tadic, Marijana; Ilic, Sanja; Cuspidi, Cesare; Stojcevski, Biljana; Ivanovic, Branislava; Bukarica, Ljiljana; Jozika, Ljilja; Celic, Vera.

In: Echocardiography, Vol. 32, No. 6, 01.06.2015, p. 947-955.

Research output: Contribution to journalArticle

Tadic, Marijana ; Ilic, Sanja ; Cuspidi, Cesare ; Stojcevski, Biljana ; Ivanovic, Branislava ; Bukarica, Ljiljana ; Jozika, Ljilja ; Celic, Vera. / Left ventricular mechanics in untreated normotensive patients with type 2 diabetes mellitus : A two- and three-dimensional speckle tracking study. In: Echocardiography. 2015 ; Vol. 32, No. 6. pp. 947-955.
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abstract = "Background Our aim was to investigate left ventricular (LV) mechanics estimated by two- (2DE) and three-dimensional echocardiography (3DE) strains in subjects with type 2 diabetes mellitus (DM). Methods This cross-sectional study included 50 untreated normotensive DM subjects and 50 healthy controls similar by sex and age. All the subjects underwent adequate laboratory analyses and complete 2DE and 3DE examination. Results Left ventricular mechanics, assessed by 2DE, was impaired in all three directions. Global longitudinal 3DE strain was significantly decreased in the DM group in comparison with the controls (-17.8 ± 2.5 vs. -19.1 ± 2.7{\%}, P = 0.014). Similar results were found for 3DE global circumferential strain (-18.9 ± 2.9 vs. -20.4 ± 3.2{\%}, P = 0.01), 3DE global radial strain (40.3 ± 6.9 vs. 43.1 ± 7.3{\%}, P = 0.035), and 3DE global area strain (-29.2 ± 3.7 vs. -31 ± 4{\%}, P = 0.024). LV torsion was similar between the DM patients and the controls (2.1 ± 0.6 vs. 1.9 ± 0.5 °/cm, P = 0.073); whereas LV untwisting rate was significantly increased in the DM subjects (-114 ± 26 vs. -96 ±23 °/s, P <0.001). A multivariate analysis showed that 3DE global longitudinal and area myocardial functions were associated with HbA1c independently of 3DE LV mass index. Conclusion Left ventricular deformation obtained by 3DE is significantly impaired in the type 2 DM patients. HbA1c is independently associated with LV mechanics that implies that early anti-diabetic therapy and normalization of the fasting glucose level and HbA1c could impede further cardiac damage.",
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T1 - Left ventricular mechanics in untreated normotensive patients with type 2 diabetes mellitus

T2 - A two- and three-dimensional speckle tracking study

AU - Tadic, Marijana

AU - Ilic, Sanja

AU - Cuspidi, Cesare

AU - Stojcevski, Biljana

AU - Ivanovic, Branislava

AU - Bukarica, Ljiljana

AU - Jozika, Ljilja

AU - Celic, Vera

PY - 2015/6/1

Y1 - 2015/6/1

N2 - Background Our aim was to investigate left ventricular (LV) mechanics estimated by two- (2DE) and three-dimensional echocardiography (3DE) strains in subjects with type 2 diabetes mellitus (DM). Methods This cross-sectional study included 50 untreated normotensive DM subjects and 50 healthy controls similar by sex and age. All the subjects underwent adequate laboratory analyses and complete 2DE and 3DE examination. Results Left ventricular mechanics, assessed by 2DE, was impaired in all three directions. Global longitudinal 3DE strain was significantly decreased in the DM group in comparison with the controls (-17.8 ± 2.5 vs. -19.1 ± 2.7%, P = 0.014). Similar results were found for 3DE global circumferential strain (-18.9 ± 2.9 vs. -20.4 ± 3.2%, P = 0.01), 3DE global radial strain (40.3 ± 6.9 vs. 43.1 ± 7.3%, P = 0.035), and 3DE global area strain (-29.2 ± 3.7 vs. -31 ± 4%, P = 0.024). LV torsion was similar between the DM patients and the controls (2.1 ± 0.6 vs. 1.9 ± 0.5 °/cm, P = 0.073); whereas LV untwisting rate was significantly increased in the DM subjects (-114 ± 26 vs. -96 ±23 °/s, P <0.001). A multivariate analysis showed that 3DE global longitudinal and area myocardial functions were associated with HbA1c independently of 3DE LV mass index. Conclusion Left ventricular deformation obtained by 3DE is significantly impaired in the type 2 DM patients. HbA1c is independently associated with LV mechanics that implies that early anti-diabetic therapy and normalization of the fasting glucose level and HbA1c could impede further cardiac damage.

AB - Background Our aim was to investigate left ventricular (LV) mechanics estimated by two- (2DE) and three-dimensional echocardiography (3DE) strains in subjects with type 2 diabetes mellitus (DM). Methods This cross-sectional study included 50 untreated normotensive DM subjects and 50 healthy controls similar by sex and age. All the subjects underwent adequate laboratory analyses and complete 2DE and 3DE examination. Results Left ventricular mechanics, assessed by 2DE, was impaired in all three directions. Global longitudinal 3DE strain was significantly decreased in the DM group in comparison with the controls (-17.8 ± 2.5 vs. -19.1 ± 2.7%, P = 0.014). Similar results were found for 3DE global circumferential strain (-18.9 ± 2.9 vs. -20.4 ± 3.2%, P = 0.01), 3DE global radial strain (40.3 ± 6.9 vs. 43.1 ± 7.3%, P = 0.035), and 3DE global area strain (-29.2 ± 3.7 vs. -31 ± 4%, P = 0.024). LV torsion was similar between the DM patients and the controls (2.1 ± 0.6 vs. 1.9 ± 0.5 °/cm, P = 0.073); whereas LV untwisting rate was significantly increased in the DM subjects (-114 ± 26 vs. -96 ±23 °/s, P <0.001). A multivariate analysis showed that 3DE global longitudinal and area myocardial functions were associated with HbA1c independently of 3DE LV mass index. Conclusion Left ventricular deformation obtained by 3DE is significantly impaired in the type 2 DM patients. HbA1c is independently associated with LV mechanics that implies that early anti-diabetic therapy and normalization of the fasting glucose level and HbA1c could impede further cardiac damage.

KW - diabetes mellitus

KW - left ventricle

KW - speckle tracking imaging

KW - three-dimensional echocardiography

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