The effect of type 2 diabetes mellitus on multiple obstructive coronary artery disease
The effect of type 2 diabetes mellitus on multiple obstructive coronary artery disease
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2 型糖尿病对多发性阻塞性冠状动脉疾病的影响。
DOI：
10.1111/echo.15539
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发表时间：
2023-02-15
影响因子：
1.5
通讯作者：
Wang，Li
中科院分区：
文献类型：
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作者：
Jiang，Luying;Liu，Jingbo;Wang，Li
虽然2型糖尿病（T2DM）患者很容易发展为三支血管疾病（3VD）冠状动脉疾病（CAD），但关于他们左心室（LV）功能的信息很少。本研究的目的是利用二维斑点跟踪超声心动图（2 - D STE）评估T2DM合并3VD患者的左室功能。方法将103例确诊为3VD的冠心病患者分为两组，合并糖尿病患者53例，未合并糖尿病患者50例。对照组由30名年龄和性别匹配的健康个体组成。所有患者均行2维STE和标准超声心动图检查。同时记录糖尿病持续时间和HbA1c水平。结果3VD - DM组和3VD -非DM组超声心动图无明显差异。然而，通过2维STE应变测量，3VD‐DM患者的整体纵向应变（GLS）明显低于3VD‐非DM患者（15.87±2.51 vs.17.56±2.72,p< 0.05）。糖尿病病程超过5年的患者GLS明显低于病程小于5年的患者（14.25±2.31∶16.65±1.96,p= .007）。然而，HbA1c≥7%和HbA1c < 7%的3VD - DM患者的GLS没有差异。结论与单纯3VD患者相比，合并3VD - DM患者的心功能较低。在3VD - DM患者中，糖尿病持续时间是心功能恶化的重要因素，而血糖控制状态的影响有限。
BackgroundAlthough type 2 diabetes mellitus (T2DM) individuals easily develop three‐vessel disease (3VD) coronary artery disease (CAD), there is very little information available about their left ventricle (LV) functions. The purpose of this study is to evaluate the LV function using two‐dimensional speckle tracking echocardiography (2‐D STE) in T2DM patients with 3VD.MethodsOne hundred and three consecutive patients with confirmed 3VD CAD were enrolled and divided into two groups, while 53 patients with DM and 50 patients without. The control group was composed of 30 age‐ and sex‐matched healthy individuals. All patients underwent 2‐D STE and standard echocardiograms. The durations of DM and the level of HbA1c were also recorded.ResultBetween the 3VD‐DM and 3VD‐non‐DM groups, normal echocardiography did not reveal any appreciable differences. However, patients with 3VD‐DM had significantly lower global longitudinal strain (GLS) than those with 3VD‐non‐DM (15.87 ± 2.51 vs.17.56 ± 2.72,p< .05) by 2‐D STE strain measurement. Besides, patients whose duration of DM excess 5 years showed significant lower GLS than those with less than 5 years duration (14.25 ± 2.31 vs. 16.65 ± 1.96,p= .007). However, there was no difference in GLS between the 3VD‐DM patients with HbA1c ≥ 7% and HbA1c < 7%.ConclusionsCompared to patients with 3VD alone, those with 3VD‐DM have a lower cardiac function. In 3VD‐DM patients, the duration of DM is a significant factor that contributes to cardiac function deterioration, whereas, the glucose control state has limited influence.