QUANTITATIVE ANALYSIS OF THE MAGNITUDE AND TIME DELAY OF CYCLIC VARIATION OF MYOCARDIAL BACKSCATTER FROM ASYMPTOMATIC TYPE 2 DIABETES MELLITUS SUBJECTS
QUANTITATIVE ANALYSIS OF THE MAGNITUDE AND TIME DELAY OF CYCLIC VARIATION OF MYOCARDIAL BACKSCATTER FROM ASYMPTOMATIC TYPE 2 DIABETES MELLITUS SUBJECTS
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DOI：
10.1016/j.ultrasmedbio.2009.04.003
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发表时间：
2009-09-01
影响因子：
2.9
通讯作者：
Miller, James G.
中科院分区：
文献类型：
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作者：
Gibson, Allyson A.;Schaffer, Jean E.;Miller, James G.
早期发现糖尿病患者发生糖尿病性心肌病的高风险可能允许有效的干预。这项工作的目的是确定是否测量心肌背向散射的周期性变化的幅度和时间延迟，单独和组合，可以用来区分亚组的个人，包括正常对照和无症状的2型糖尿病受试者。对104例2型糖尿病患者和44例正常人进行胸骨旁长轴二维超声心动图检查。循环变化数据通过测量后壁中感兴趣区域内的平均心肌背向散射水平产生，并以幅度和归一化时间延迟为特征。使用贝叶斯分类和受试者工作特征（ROC）曲线下面积的非参数估计来分析循环变异参数，以说明使用一个或两个特征来分离个体亚组的相对有效性。根据糖化血红蛋白（HbA1c）、胰岛素抵抗稳态模型评估（HOMA-IR）和甘油三酯/高密度脂蛋白胆固醇（TG/HDL-C）比值对受试者进行分组。比较HbA1c、HOMA-IR和TG/HDL-C最高和最低四分位数受试者的循环变异测量值的分析显示，循环变异的平均幅度和标准化时间延迟存在显著差异。结果表明，分析年轻无症状2型糖尿病患者的背向散射周期变化可能是糖尿病心肌病发展的早期指标。（电子邮件：james. g. miller@www.example.com）（C）2009年世界医学和生物学超声联合会。
Early detection of diabetic patients at high risk for developing diabetic cardiomyopathy may permit effective intervention. The goal of this work is to determine whether measurements of the magnitude and time delay of cyclic variation of myocardial backscatter, individually and in combination, can be used to discriminate between subgroups of individuals including normal controls and asymptomatic type 2 diabetes subjects. Two-dimensional parasternal long-axis echocardiographic images of 104 type 2 diabetic patients and 44 normal volunteers were acquired. Cyclic variation data were produced by measuring the mean myocardial backscatter level within a region-of-interest in the posterior wall, and characterized in terms of the magnitude and normalized time delay. The cyclic variation parameters were analyzed using Bayes classification and a nonparametric estimate of the area under the receiver operating characteristic (ROC) curve to illustrate the relative effectiveness of using one or two features to segregate subgroups of individuals. The subjects were grouped based on glycated hemoglobin (HbA1c), the homeostasis model assessment for insulin resistance (HOMA-IR) and the ratio of triglyceride to high-density lipoprotein cholesterol (TG/HDL-C). Analyses comparing the cyclic variation measurements of subjects in the highest and lowest quartiles of HbA1c, HOMA-IR and TG/HDL-C showed substantial differences in the mean magnitude and normalized time delay of cyclic variation. Results show that analyses of the cyclic variation of backscatter in young asymptomatic type 2 diabetics may be an early indicator for the development of diabetic cardiomyopathy. (E-mail: james.g.miller@wustl.edu) (C) 2009 World Federation for Ultrasound in Medicine & Biology.