Impaired Myocardial Radial Function in Asymptomatic Patients with Type 2 Diabetes Mellitus: A Speckle-Tracking Imaging Study
Impaired Myocardial Radial Function in Asymptomatic Patients with Type 2 Diabetes Mellitus: A Speckle-Tracking Imaging Study
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DOI：
10.1016/j.echo.2010.09.007
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发表时间：
2010-12-01
影响因子：
6.5
通讯作者：
Derumeaux, Genevieve
中科院分区：
文献类型：
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作者：
Ernande, Laura;Rietzschel, Ernst R.;Derumeaux, Genevieve
背景：糖尿病心肌病的特点是左心室 (LV) 纵向功能早期受损，而不是保留 LV 径向功能。方法：在 114 名 2 型糖尿病患者和 88 名患者中获得了传统超声心动图以及通过斑点跟踪成像评估的纵向 (epsilon(L)) 和径向 (epsilon(R)) 收缩应变。 年龄匹配的对照。结果：糖尿病患者和对照的左心室射血分数相似。糖尿病患者存在亚临床左室收缩功能障碍，表现为中壁缩短分数较低（18% +/- 3% vs 20% +/- 3%，P = .006）、epsilon(L)（-19% +/- 3% vs -22% +/- 2%，P < .001）和 epsilon(R)（50% +/- 16% vs 56% +/- 12%, P = .003) 与对照组相比。在多变量分析中，预测应变值的因素为糖尿病 (P = .001) 和 epsilon(L) 的性别 (P = .001)，以及 epsilon(R) 的糖尿病 (P = .003)。结论：即使在调整血压、年龄和体重指数后，无明显心脏病的糖尿病患者仍表现出径向和纵向 LV 收缩功能的亚临床改变。 (J Am Soc Echocardiogr 2010；23:1266-72。)
Background: Diabetic cardiomyopathy has been characterized by an early impairment of left ventricular (LV) longitudinal function as opposed to preserved LV radial function.Methods: Conventional echocardiography and longitudinal (epsilon(L)) and radial (epsilon(R)) systolic strain assessed by speckle-tracking imaging were obtained in 114 type 2 diabetic patients and 88 age-matched controls.Results: LV ejection fraction was similar in diabetic patients and controls. The presence of subclinical LV systolic dysfunction in diabetic patients was demonstrated by lower values of midwall fractional shortening (18% +/- 3% vs 20% +/- 3%, P = .006), epsilon(L) (-19% +/- 3% vs -22% +/- 2%, P < .001), and epsilon(R) (50% +/- 16% vs 56% +/- 12%, P = .003) compared with controls. On multivariate analysis, factors predicting strain values were diabetes (P = .001) and gender (P = .001) for epsilon(L) and diabetes (P = .003) for epsilon(R).Conclusion: Diabetic patients without overt heart disease display subclinical alteration of both radial and longitudinal LV systolic function even after adjustment for blood pressure, age, and body mass index. (J Am Soc Echocardiogr 2010;23:1266-72.)