title: Impact of myocardial acceleration during isovolumic contraction in evaluating subclinical right ventricular systolic dysfunction in type 2 diabetes mellitus patients.
abstract: OBJECTIVE
  In diabetes mellitus (DM) patients, left ventricular dysfunction is widely evaluated and established by conventional diagnostic methods, whereas right ventricular (RV) function is not as sufficiently evaluated. The aim of this study is to assess the preclinical effects of DM on RV function by using novel Tissue Doppler Imaging (TDI)-derived indices.
  
  
  METHODS
  The study included 96 patients with type II DM [60 with DM only and 36 patients with coexisting DM and hypertension (DMHT)] and 40 healthy controls. Conventional parameters and TDI-derived systolic velocities of tricuspid annulus [isovolumic myocardial acceleration (IVA), peak myocardial velocity during isovolumic contraction (IVV), peak systolic velocity during ejection period (Sa), RV Tei index] were measured.
  
  
  RESULTS
  TDI-derived RV IVA was significantly lower in both DM and DMHT patients compared to controls indicating subclinical impairment in RV systolic function in the study patients (P = 0,0001). However RV IVA was similar in DM and DMHT subgroup supporting RV systolic impairment in DM was independent from HT. In correlation analysis, RV IVA was significantly correlated with the existence of diabetic nephropathy (r =-0,38; P = 0,003), retinopathy (r =-0,35; P = 0,006), insulin resistance (r =-0,52; P = 0,0001).
  
  
  CONCLUSIONS
  Diabetes is associated with subclinical RV systolic dysfunction, regardless of coexisting hypertension. Tissue Doppler-derived IVA; is a novel, non-invasive parameter which may be used in early detection of RV systolic dysfunction in patients with DM.
authors.affiliation: Cardiology Division, Florence Nightingale Hospital, Istanbul, Turkey. yeldatayyareci@hotmail.com
authors.forename: Yelda
authors.initials: Y
authors.lastname: Tayyareci
authors.forename: Selen
authors.initials: S
authors.lastname: Yurdakul
authors.forename: Gulsah
authors.initials: G
authors.lastname: Tayyareci
authors.forename: Yilmaz
authors.initials: Y
authors.lastname: Nisanci
authors.forename: Berrin
authors.initials: B
authors.lastname: Umman
authors.forename: Zehra
authors.initials: Z
authors.lastname: Buğra
mesh_terms: D000054:Acceleration; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D014463:Ultrasonography; D018497:Ventricular Dysfunction, Right / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology*