title: Findings from left ventricular strain and strain rate imaging in asymptomatic patients with type 2 diabetes mellitus.
abstract: Regional left ventricular (LV) myocardial functional changes in early diabetic cardiomyopathy have not been well documented. LV multidirectional strain and strain rate analyses by 2-dimensional speckle tracking were used to detect subtle myocardial dysfunction in 47 asymptomatic, male patients (age 57 +/- 6 years) with type 2 diabetes mellitus. The results were compared to those from 53 male controls matched by age, body mass index, and body surface area. No differences were found in the LV end-diastolic volume index (40.7 +/- 8.9 vs 44.1 +/- 7.8 ml/m(2), p = NS), end-systolic volume index (16.0 +/- 4.8 vs 17.8 +/- 4.3 ml/m(2), p = NS), ejection fraction (61.0 +/- 5.5% vs 59.8 +/- 5.3%, p = NS). The transmitral E/A (0.95 +/- 0.21 vs 1.12 +/- 0.32, p = 0.007) and pulmonary S/D (1.45 +/- 0.28 vs 1.25 +/- 0.27, p = 0.001) ratios were more impaired in the patients with diabetes mellitus. Importantly, the diabetic patients had impaired longitudinal, but preserved circumferential and radial systolic and diastolic, function. Diabetes mellitus was an independent predictor for longitudinal strain, systolic strain rate and early diastolic strain rate on multiple linear regression analysis (all p <0.001). In conclusion, the LV longitudinal systolic and diastolic function were impaired, but the circumferential and radial functions were preserved in patients with uncomplicated type 2 diabetes mellitus.
authors.affiliation: Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Arnold C T
authors.initials: AC
authors.lastname: Ng
authors.forename: Victoria
authors.initials: V
authors.lastname: Delgado
authors.forename: Matteo
authors.initials: M
authors.lastname: Bertini
authors.forename: Rutger W
authors.initials: RW
authors.lastname: van der Meer
authors.forename: Luuk J
authors.initials: LJ
authors.lastname: Rijzewijk
authors.forename: Miriam
authors.initials: M
authors.lastname: Shanks
authors.forename: Gaetano
authors.initials: G
authors.lastname: Nucifora
authors.forename: Johannes W A
authors.initials: JW
authors.lastname: Smit
authors.forename: Michaela
authors.initials: M
authors.lastname: Diamant
authors.forename: Johannes A
authors.initials: JA
authors.lastname: Romijn
authors.forename: Albert
authors.initials: A
authors.lastname: de Roos
authors.forename: Dominic Y
authors.initials: DY
authors.lastname: Leung
authors.forename: Hildo J
authors.initials: HJ
authors.lastname: Lamb
authors.forename: Jeroen J
authors.initials: JJ
authors.lastname: Bax
mesh_terms: D001783:Blood Flow Velocity / Q000502:physiology; D009202:Cardiomyopathies / Q000503:physiopathology; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D003971:Diastole / Q000502:physiology; D004452:Echocardiography; D006339:Heart Rate / Q000502:physiology; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011652:Pulmonary Circulation / Q000502:physiology; D013599:Systole / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology*