Echocardiography, an Indispensable Tool for the Management of Diabetics, with or without Coronary Artery Disease, in Clinical Practice

Abstract

Diabetes mellitus is a major factor contributing to the development of cardiovascular disease. As morbidity and mortality rates rise dramatically, when target organ damage develops pre-symptomatic assessment is critical for the management of diabetic patients. Echocardiography is a noninvasive and reproducible method that may aid in risk stratification and in evaluation of treatment effects. The aim of this review is to analyze the echocardiographic techniques which can detect early alteration in cardiac function in patients with diabetes.

Métodos diagnósticos cardiovasculares en pacientes con diabetes mellitus. Revisión

“…8,10 Por otro lado, el patrón fenotípico dilatado se ha asociado más a un mecanismo de autoinmunidad que deriva en IC, principalmente en pacientes con diabetes mellitus tipo 1. [8][9][10][11] (Figura 2B). La teoría de la autoinmunidad implicada en el desarrollo de MCD con un patrón fenotípico dilatado se conformó debido a autoanticuerpos de miosina cardíaca identificados en pacientes con diabetes mellitus tipo 1 después de un infarto, hallazgos que sugirieron un "síndrome autoinmune posinfarto" en ese tipo de pacientes, lo que exacerbaba el daño celular producido por la glucotoxicidad, la lipotoxicidad y los radicales libres, así como el mayor riesgo de IC con FEVI disminuida.…”

“…Los rangos de llenado ventricular se ven alterados en presencia de disfunción diastólica, 2 que se manifiesta por reducción en la velocidad de la onda E, con aumento en la onda A y tiempo prolongado de desaceleración de la onda E, lo que corresponde a disfunción diastólica. 1,9 • Doppler tisular. Es importante el análisis del movimiento anular mitral diastólico: ondas e' y a'.…”

The Role of Mitochondrial Abnormalities in Diabetic Cardiomyopathy

“…Structural changes in diabetic myocardium are usually assessed by non-invasive reliable and reproducible techniques (such as magnetic resonance imaging and echocardiography), with myocardial fibrosis and hypertrophy as the main hallmarks of DCM [ 12 , 13 ]. While MRI has better sensitivity and capability to provide a more detailed image, it is also more expensive, thus, not so widely used as echocardiography––the main diagnostic tool for the early DCM detection [ 14 , 15 ].…”

Role of Echocardiography in Diabetic Cardiomyopathy: From Mechanisms to Clinical Practice

“…However, what is less appreciated is the fact that DM may affect cardiac function irrespective of cardiac pathologies to which it contributes, such as coronary artery disease (CAD). Rubler et al coined the term diabetic cardiomyopathy (DCM), back in 1972, after studying autopsy analysis of four diabetics who died of HF, without indication of CAD or any other pathology that could enlighten the spotted structural changes [ 4 , 5 ]. Nowadays, although universal definition does not exist, DCM is usually defined by the presence of abnormal myocardial architecture and malfunctioning, without any evidence of existing cardiovascular risk factors, such as CAD, hypertension, and significant valvular disease among individuals with DM [ 6 ].…”