Presystolic Wave is Associated with Subclinical Left Ventricular Dysfunction Assessed by Myocardial Performance Index in Type 2 Diabetes Mellitus

Abstract

BackgroundMyocardial performance index (MPI), demonstrates both systolic and diastolic functions of the left ventricle. Presystolic wave (PSW) is frequently detected on Doppler examination of the left ventricular outflow tract and possible mechanism of PSW is impaired LV compliance and left ventricular stiffness.ObjectiveTo investigate the relationship between PSW and MPI in type 2 diabetic patients.MethodA total of 129 type 2 diabetic patients were included in this study. Patients were divided into two groups according to the presence of PSW on Doppler echocardiography. There were 90 patients (38 male, mean age 57.77 ± 10.91 years) in the PSW-positive group and 39 patients (13 male; mean age: 55.31 ± 11.29 years) in the PSW-negative group. The p values of < 0.05 were considered statistically significant.ResultsMPI was higher in PSW- positive group (0.63 ± 0.17vs 0.52 ± 0.13, p < 0.001). In addition, subclinical left ventricle dysfunction (LVD) was higher in the PSW- positive group (p = 0.029). Univariate analysis showed that the presence of PSW associated with abnormal MPI (p = 0.031). Pearson correlation analysis showed that PSW velocity correlated with MPI (r: 0.286, p = 0.006).ConclusionPresence of the PSW on Doppler examination was associated with subclinical LV dysfunction in patients with DM type 2. This easy-to-perform echocardiographic parameter may be related to subclinical LVD among patients with type 2 DM.

Prevalence of the presystolic wave in echocardiography and its association with the extent of coronary artery disease in patients with chronic stable angina

“…The prevalence of the PSW was the same in subjects with and without common atherosclerotic risk factors (eg, DM, HTN, DLP, and smoking). In another study on 129 patients with DM type 2, the prevalence of PSW was 69.8% (90/129), which was higher than the findings of our study (49.1%) 17 . EF was lower than 50%, in 55.5% of the patients, while in the mentioned study, the mean EF was above 60% which might explain the lower prevalence of the PSW in our study 17 …”

“…In another study on 129 patients with DM type 2, the prevalence of PSW was 69.8% (90/129), which was higher than the findings of our study (49.1%). 17 EF was lower than 50%, in 55.5% of the patients, while in the mentioned study, the mean EF was above 60%…”

“…which might explain the lower prevalence of the PSW in our study. 17 Furthermore, the PSW was significantly more prevalent among patients without a history of previous myocardial infarction and RWMA (P = .002). It could be proposed that PSW might be more prevalent in patients with better cardiac function and physiology.…”

The presystolic wave was not sufficient for diagnosing subclinical left ventricular diastolic dysfunction in hemodialysis patients

“…Joshi KR et al 20 have found that the absence of PSW is associated with increased frequency of adverse event and one study have shown that PSW is an indicator of impaired compliance of LV 21 . Kul S. et al 22 have found that PSW is associated with subclinical LV diastolic dysfunction in patients with DM. Akyuz AR et al 23 have detected that PSW is an independent predictor of subclinical LV dysfunction in patients with HT.…”

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“…Presystolic wave (PSW) measurement is obtained via doppler examination of LV outflow tract (LVOT). 5,6 Kul et al 7 found that the PSW is associated with subclinical LVDD in patients with type 2 diabetes. PSW is an easily measurable echocardiographic parameter obtained in late diastole and can predict subclinical left ventricular dysfunction in patients with type 2 diabetes.…”