title: Longitudinal left ventricular function in normotensive prediabetics: a tissue Doppler and strain/strain rate echocardiography study.
abstract: BACKGROUND
  Although diabetes mellitus is well known to result in systolic and diastolic left ventricular (LV) dysfunction at the subclinical level, even when it is not accompanied by hypertension and coronary artery disease, this situation has not been sufficiently investigated in prediabetes, which is the precursor of diabetes. The aims of the present study were to investigate LV systolic and diastolic function in normotensive and low-risk prediabetic and diabetic subjects for coronary disease using sensitive tissue Doppler echocardiographic parameters, to investigate early possible negative effects of glucose metabolism impairment on LV longitudinal function.
  
  
  METHODS
  Two hundred subjects (92 with prediabetes, 48 with type 2 diabetes, and 60 age-matched healthy volunteers) were studied by conventional, tissue Doppler, and strain and strain rate echocardiography. All study subjects were normotensive, and coronary artery disease was excluded. Forty-eight patients had isolated fasting glucose impairment, and 44 patients had combined fasting glucose and glucose tolerance impairment. Longitudinal peak systolic strain and the peak systolic and diastolic strain rates of six walls in the apical four-chamber, long-axis, and two-chamber views were evaluated.
  
  
  RESULTS
  Clinical and standard echocardiographic characteristics were comparable among all groups. Mean systolic (P = .01) and diastolic (P = .02) tissue velocities, mean strain (P = .004), and mean systolic (P = .002) and diastolic (P = .001) strain rates were significantly lower in the diabetic groups than in control subjects. There were no difference between patients with isolated fasting glucose impairment and controls for tissue Doppler parameters, but mean early diastolic tissue velocity and mean strain and strain rates were statistically lower in patients with combined fasting glucose and glucose tolerance impairment compared with controls (P < .05).
  
  
  CONCLUSIONS
  LV longitudinal systolic and diastolic function was impaired in both normotensive diabetic and prediabetic patients.
authors.affiliation: Department of Cardiology, Gaziosmanpasa University Faculty of Medicine, Tokat, Turkey. kceyhan09@yahoo.com
authors.forename: Köksal
authors.initials: K
authors.lastname: Ceyhan
authors.forename: Hasan
authors.initials: H
authors.lastname: Kadi
authors.forename: Fatih
authors.initials: F
authors.lastname: Koç
authors.forename: Ataç
authors.initials: A
authors.lastname: Celik
authors.forename: Ahmet
authors.initials: A
authors.lastname: Oztürk
authors.forename: Orhan
authors.initials: O
authors.lastname: Onalan
mesh_terms: D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000000981:diagnostic imaging / Q000473:pathology*; D003971:Diastole; D005260:Female; D006305:Health Status Indicators; D006331:Heart Diseases / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000000981:diagnostic imaging / Q000473:pathology*; D018570:Risk Assessment / Q000379:methods; D013223:Statistics as Topic; D013318:Stroke Volume; D013599:Systole; D013997:Time Factors; D018608:Ultrasonography, Doppler / Q000295:instrumentation*; D016277:Ventricular Function, Left / Q000502:physiology*