Comparison of left ventricular function by tissue Doppler imaging in patients with diabetes mellitus without systemic hypertension versus diabetes mellitus with systemic hypertension

Kosmala, Wojciech; Kucharski, Wojciech; Przewlocka‐Kosmala, M.; Mazurek, Walentyna

doi:10.1016/j.amjcard.2004.04.048

Cited by 62 publications

(56 citation statements)

References 16 publications

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“…39 In addition, we were not able to apply the relatively new echocardiographic techniques of colour M-mode and tissue Doppler, which may provide more accurate estimates of diastolic or systolic function. 40,41 In conclusion, in the present study, we confirm earlier studies that show a high prevalence of LV structural and functional abnormalities in persons with type II diabetes, especially when combined with hypertension. [5][6][7] The alarming high prevalence of insufficiently treated diabetic subjects with hypertension in this population-based study shows that translating the recommendations of clinical guidelines and the findings from research studies into daily clinical practice remains a daunting challenge.…”

Section: Study Limitationssupporting

confidence: 80%

Influence of antihypertensive therapy and blood pressure control on left ventricular geometry and function in subjects with type II diabetes: The Augsburg Diabetes Family Study

et al. 2006

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Cross-sectional data often fail to show beneficial effects of antihypertensive therapy in patients with hypertension. We, therefore, examined the influence of hypertension control on left ventricular (LV) structure in diabetic persons separated into those having and not having any known cardiovascular disease (CVD) symptoms. The study population consisted of 394 subjects with type II diabetes. According to the presence of CVD, subjects were classified as symptomatic (N ¼ 181) or asymptomatic (N ¼ 213). In addition, three groups were differentiated: controlled hypertensives (CHs), that is, known hypertension with normal blood pressure (BP), uncontrolled hypertensives (UHs), that is, elevated BP regardless of antihypertensive medication, and normotensives (Ns). Symptomatic subjects showed a significantly higher prevalence of LV hypertrophy (LVH) (34.5 vs 23.4%, Po0.02). In contrast to symptomatic subjects where hypertension control status had no further significant impact on LV geometry, a considerable impact on preservation of normal LV geometry was observed in asymptomatic persons (LVH of 30, 15 and 18% in UH, CH and N, respectively, Po0.001). Control of hypertension in early diabetes seems especially to prevent the development of concentric hypertrophy (24 vs 11% in UH vs CH, Po0.04). In conclusion, in subjects with diabetes and CVD, the prevalence of LV structural abnormalities is very high. Although in this populationbased study setting, in the latter group BP control does not seem to positively influence LV mass and function, hypertension control in still asymptomatic diabetic persons is beneficial and has a considerable impact on preservation of normal LV geometry.

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Section: Study Limitationssupporting

confidence: 80%

Influence of antihypertensive therapy and blood pressure control on left ventricular geometry and function in subjects with type II diabetes: The Augsburg Diabetes Family Study

et al. 2006

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“…Also, we identified that ETV values in obese patients increased; thus, validating hemodynamic alterations previously presented by the patients before a decrease in LVEF occurs [21,22]. Surprisingly, in contrast with the revised literature [13][14][15] we did not found differences when comparing DM with non-DM groups. Statistically significant differences in EDS and ESV in both sex groups, while preliminary, suggest that men had higher values of these parameters even after adjusting for other possible cofounders.…”

Section: Discussioncontrasting

confidence: 54%

“…Left ventricular dysfunction has been strongly associated with diabetes mellitus [13]. There is also evidence suggesting that patients who have type II diabetes but no clinically apparent heart disease have impaired function of the left ventricle both in ESV and EDV in both at rest 1 clearly shows a higher percentage of LVEF in the normal weight diabetic patients.…”

Section: Introductionmentioning

confidence: 86%

Gated-SPECT Functional Assessment in Overweight and Obese Patients

Puente-Barragán¹,

Morales-Portano²

2015

J Cardiovasc Dis Diagn

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“…Recently, tissue Doppler echocardiography has been used in patients with subclinical LV dysfunction because the parameters derived from it are sensitive and independent of LV preload. 22,23) However, E' from tissue Doppler echocardiography is an LV diastolic functional parameter that reflects regional LV function measured at the mitral annulus. Therefore, E' may be different from global LV functional parameters such as the Tei index.…”

Section: Discussionmentioning

confidence: 99%

Independent Determinants of the Tei Index in Hypertensive Patients With Preserved Left Ventricular Systolic Function

et al. 2009

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SummaryThe clinical usefulness of the Tei index, which reflects left ventricular (LV) systolic and diastolic function, is known to have prognostic value in patients with overt heart disease such as ischemic heart disease or congestive heart failure. Additionally, LV diastolic functional parameters such as the transmitral E/A (early to atrial velocity) ratio have been shown to have prognostic value in hypertensive patients. However, the clinical usefulness of the Tei index for hypertensive patients without overt heart disease has not yet been fully studied. We compared the Tei index between hypertensive and normotensive patients and examined independent determinants of the Tei index in hypertensive patients with preserved LV systolic function. Our subjects were 319 patients with cardiovascular risk factors including hypertension and diabetes, all of whom had preserved LV systolic function (LV ejection fraction ≥ 55%). They were divided into two groups: 100 normotensives (67 ± 11 years) and 219 hypertensives (69 ± 13 years). LV structural and functional parameters including transmitral E/A ratio and the Tei index were measured with Doppler echocardiography. The correlations of the transmitral E velocity to the Tei index (r = -0.311, P < 0.001) were the closest in all echocardiographic parameters in hypertensives.Stepwise regression analysis showed that E velocity (β coefficient = -0.315, P < 0.001) and relative wall thickness (β coefficient = 0.262, P < 0.001) were independently associated with the Tei index. The Tei index in hypertensives with preserved LV systolic function may be determined primarily by LV diastolic dysfunction during early diastole with LV concentric remodeling and may, together with the E/A ratio, have prognostic value in hypertensive patients. (Int Heart J 2009; 50: 331-340)

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Comparison of left ventricular function by tissue Doppler imaging in patients with diabetes mellitus without systemic hypertension versus diabetes mellitus with systemic hypertension

Cited by 62 publications

References 16 publications

Influence of antihypertensive therapy and blood pressure control on left ventricular geometry and function in subjects with type II diabetes: The Augsburg Diabetes Family Study

Influence of antihypertensive therapy and blood pressure control on left ventricular geometry and function in subjects with type II diabetes: The Augsburg Diabetes Family Study

Gated-SPECT Functional Assessment in Overweight and Obese Patients

Independent Determinants of the Tei Index in Hypertensive Patients With Preserved Left Ventricular Systolic Function

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