The influence of type 2 diabetes and arterial hypertension on right ventricular layer-specific mechanics.
OBJECTIVE
The aim of the investigation was to evaluate layer-specific right ventricular (RV) deformation in normotensive and hypertensive subjects with type 2 diabetes mellitus (DM).


METHODS
This cross-sectional study included 129 subjects (40 controls, 42 normotensive DM and 47 hypertensive DM patients) who underwent complete two-dimensional echocardiographic examination (2DE) including multilayer strain analysis.


RESULTS
2DE RV global and free wall longitudinal strains were reduced in normotensive and hypertensive DM subjects than in controls. RV global longitudinal layer-specific strains (endo-, mid- and epicardial) were lower in normotensive and hypertensive DM patients than in controls. On the other side, layer-specific strains of RV free wall were lower in hypertensive DM patients than in controls, without significant difference between controls and normotensive DM subjects. Parameters of DM control (fasting glucose and glycosylated hemoglobin) were associated with 2DE RV global longitudinal endo- and mid-myocardial layer strain.


CONCLUSIONS
Diabetes and hypertension significantly influence RV mechanics assessed by 2DE conventional and 2DE multilayer strain. Hypertension has an additive unfavorable influence on RV deformation in diabetic patients. Laboratory parameters of diabetic control were associated with RV structure, diastolic function and mechanics assessed with complex 2DE strain analysis.
Department of Cardiology, University Hospital "Dr Dragisa Misovic - Dedinje", Heroja Milana Tepica 1, Belgrade, 11000, Serbia. marijana_tadic@hotmail.com.|Faculty of Medicine, Doktora Subotica 6, Belgrade, 11000, Serbia. marijana_tadic@hotmail.com.
Marijana
M
Tadic
Clinical Research Unit, University of Milan-Bicocca and Istituto Auxologico Italiano, Viale della Resistenza 23, 20036, Meda, Italy.
Cesare
C
Cuspidi
Department of Cardiology, University Hospital "Dr Dragisa Misovic - Dedinje", Heroja Milana Tepica 1, Belgrade, 11000, Serbia.
Vladan
V
Vukomanovic
Department of Endocrinology, University Hospital "Dr Dragisa Misovic - Dedinje", Heroja Milana Tepica 1, Belgrade, 11000, Serbia.
Sanja
S
Ilic
Department of Cardiology, University Hospital "Dr Dragisa Misovic - Dedinje", Heroja Milana Tepica 1, Belgrade, 11000, Serbia.|Faculty of Medicine, Doktora Subotica 6, Belgrade, 11000, Serbia.
Vera
V
Celic
Faculty of Health Sciences, LAPEC EA4278, Avignon University, 84000, Avignon, France.
Philippe
P
Obert
Department of Cardiology, University Hospital "Dr Dragisa Misovic - Dedinje", Heroja Milana Tepica 1, Belgrade, 11000, Serbia.
Vesna
V
Kocijancic
D000328:Adult; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology*; D004452:Echocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D016278:Ventricular Function, Right
Diabetes; Hypertension; Multilayer strain; Right ventricle; Two-dimensional speckle tracking