Early detection of diabetic cardiomyopathy: usefulness of tissue Doppler imaging
Early detection of diabetic cardiomyopathy: usefulness of tissue Doppler imaging
复制标题
DOI：
10.1111/j.1464-5491.2005.01685.x
复制
发表时间：
2005-12-01
影响因子：
3.5
通讯作者：
Sibilio, G
中科院分区：
文献类型：
--
作者：
Bonito, P;Moio, N;Sibilio, G
目的 本研究的目的是评估组织多普勒成像 (TDI) 是否可以通过常规超声心动图 (CE) 检测病程短、心功能正常的 2 型糖尿病受试者的临床前舒张功能受损，以及超声心动图参数是否与代谢异常相关。 患者和方法 我们研究了 40 名非肥胖、血压正常、无并发症的病程短的 2 型糖尿病受试者和 20 名对照受试者。所有参与者均接受了 CE 和 TDI 超声心动图检查。使用 TDI，在二尖瓣环外侧角测量早期流速 (Ea)、心房流速 (Aa)、它们的比值 (Ea/Aa) 和收缩期流速 (Sa)。测定糖化血红蛋白、空腹血糖和胰岛素，并计算作为胰岛素抵抗指标的稳态模型评估（HOMA-IR）。结果两组的心功能CE相似。使用 TDI，糖尿病受试者表现出较低的 Ea 速度（15.5 +/- 3.9 对比 19.4 +/- 3.5 cm/s，P < 0.0001）、增加的 Aa 速度（15.5 +/- 2.4 对比 14.1 +/- 2.4 cm/s，P < 0.05）以及降低的 Ea/Aa 比率（1.00 +/- 0.2 对比 1.00 +/- 0.2）。 1.39 +/- 0.3，P < 0.0001），与对照组相比。糖尿病组的线性回归分析显示，只有HOMA-IR与Ea/Aa比值呈负相关（P = 0.026）。与其他代谢变量没有观察到显着相关性。 结论 即使在 CE 心功能正常的情况下，2 型糖尿病受试者中的 TDI 也可以证明糖尿病心肌病的早期阶段。这种异常与胰岛素抵抗有关。
Objective The aim of the study was to evaluate whether tissue Doppler imaging (TDI) detects a pre-clinical impairment of diastolic function in subjects with Type 2 diabetes with short duration of disease and normal cardiac function with conventional echocardiography (CE), and whether echocardiographic parameters are related to metabolic abnormalities.Patients and methods We studied 40 non-obese, normotensive, uncomplicated Type 2 diabetic subjects with short duration of disease and 20 control subjects. All participants underwent both CE and TDI echocardiography. With TDI, early velocity (Ea), atrial velocity (Aa), their ratio (Ea/Aa) and systolic velocity (Sa) were measured at the lateral corner of mitral annulus. Glycosylated haemoglobin, fasting plasma glucose and insulin were determined and homeostasis model assessment (HOMA-IR), as an index of insulin resistance, was calculated.Results Cardiac function with CE was similar in the two groups. Using TDI, diabetic subjects showed a lower Ea velocity (15.5 +/- 3.9 vs. 19.4 +/- 3.5 cm/s, P < 0.0001), an increased Aa velocity (15.5 +/- 2.4 vs. 14.1 +/- 2.4 cm/s, P < 0.05) and a reduced Ea/Aa ratio (1.00 +/- 0.2 vs. 1.39 +/- 0.3, P < 0.0001), compared with control subjects. Linear regression analysis in the diabetic group showed that only HOMA-IR was negatively associated with Ea/Aa ratio (P = 0.026). No significant association was observed with other metabolic variables.Conclusion An early stage of diabetic cardiomyopathy can be evidenced by TDI in Type 2 diabetic subjects even in the presence of a normal cardiac function with CE. This abnormality is associated with insulin resistance.