title: Subclinical left ventricular dysfunction and coronary atherosclerosis in asymptomatic patients with type 2 diabetes.
abstract: OBJECTIVE
  The aim of the present study was to evaluate whether subclinical left ventricular (LV) systolic dysfunction is independently related to subclinical coronary atherosclerosis in type 2 diabetic patients and if it could provide incremental information over baseline characteristics to identify high-risk patients.
  
  
  RESULTS
  A total of 234 asymptomatic, type 2 diabetic patients without overt LV systolic dysfunction underwent coronary artery calcium (CAC) scoring and two-dimensional echocardiography. The LV global longitudinal strain (GLS) was assessed using automated function imaging. Patients with coronary atherosclerosis (CAC > 0; n = 139) had more impaired GLS when compared with patients without coronary atherosclerosis (CAC = 0; n = 95; -18.0 ± 2.8 vs. -16.3 ± 3.0%, P < 0.001). At multivariate analysis, male gender, hypertension, hypercholesterolaemia, and the LV GLS were independently associated with coronary atherosclerosis. The addition of the LV GLS to other selected independent clinical variables significantly improved the ability to predict coronary atherosclerosis in these patients (χ(2) = 58.92; P = 0.001).
  
  
  CONCLUSIONS
  Type 2 diabetic patients with coronary atherosclerosis showed a more impaired LV GLS compared with patients without coronary atherosclerosis. The presence of subclinical LV systolic dysfunction provides significant incremental value for the identification of diabetic patients having coronary atherosclerosis.
authors.affiliation: Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, PO Box 9600, 2300 RC Leiden, The Netherlands.
authors.forename: Arthur J H A
authors.initials: AJ
authors.lastname: Scholte
authors.forename: Gaetano
authors.initials: G
authors.lastname: Nucifora
authors.forename: Victoria
authors.initials: V
authors.lastname: Delgado
authors.forename: Roxana
authors.initials: R
authors.lastname: Djaberi
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Boogers
authors.forename: Joanne D
authors.initials: JD
authors.lastname: Schuijf
authors.forename: Antje V
authors.initials: AV
authors.lastname: Kharagjitsingh
authors.forename: J Wouter
authors.initials: JW
authors.lastname: Jukema
authors.forename: Ernst E
authors.initials: EE
authors.lastname: van der Wall
authors.forename: Lucia J
authors.initials: LJ
authors.lastname: Kroft
authors.forename: Albert
authors.initials: A
authors.lastname: de Roos
authors.forename: Jeroen J
authors.initials: JJ
authors.lastname: Bax
mesh_terms: D000465:Algorithms; D002114:Calcinosis; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000473:pathology*; D003924:Diabetes Mellitus, Type 2 / Q000000981:diagnostic imaging / Q000473:pathology*; D004452:Echocardiography; D005260:Female; D006305:Health Status Indicators; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000473:pathology*