Evaluation of the longitudinal deformation of the left ventricular myocardium in subjects with impaired fasting glucose with and without increased glycated hemoglobin

Abstract

ObjectivePrediabetes comprises a heterogeneous group because of the poor concordance of its definition. The aim of our study was to evaluate the longitudinal deformation of the left ventricular (LV) myocardium at the two opposite ends of the prediabetes spectrum as defined by fasting blood sugar and glycated hemoglobin (HbA1c).MethodsEighty consecutive subjects in a cross-sectional single-center study with impaired fasting glucose (IFG) (100–126 mg/dL) and without significant epicardial coronary artery stenosis seen on selective coronary angiography were included in our study and were divided into two groups based on their HbA1c levels (<5.7% and 5.7%–6.4%). The longitudinal deformation of the LV myocardium was compared between the two groups using two-dimensional speckle-tracking echocardiography (2DSTE).ResultsThe Student t-test, Mann–Whitney U test, or X2 test was used for data analysis, whichever was appropriate. The systolic strain (–16.1%±2.0 vs. –16.8%±2.4; p=0.214), systolic strain rate (–1.3±0.2 s–1 vs. –1.4±0.2 s–1; p=0.403), and early and late-diastolic strain rates (1.4±0.3 s–1 vs. 1.5±0.3 s–1; p=0.456 and 0.9±0.1 s–1 vs. 1.0±0.2 s–1; p=0.684, respectively) of the LV myocardium were not statistically different between the IFG subjects with and without increased HbA1c as detected using 2DSTE.ConclusionThe longitudinal deformation of the LV myocardium as detected using 2DSTE in the subjects without significant epicardial coronary artery stenosis was not statistically significantly different between the IFG subjects with and without increased HbA1c.

When sweet becomes too sweet: Left ventricular longitudinal strain in focus

“…Our investigation reported that LV mass index, LA longitudinal strain, and three-dimensional LV area strain were independently associated with HbA1c in the study population that involved prediabetic and diabetic patients ( 5 ). Akavan-Khaleghi et al ( 6 ) did not find an independent association between LV GLS and HbA1c. However, the authors did not consider simple correlation analysis between HbA1c and LV GLS.…”

“…Interestingly, LV GLS significantly dropped when controls were compared with participants with isolated increased fasting glucose, whereas there was no significant difference between individuals with various levels of glucose intolerance ( 3 ). In other words, the most important feature that induced LV remodeling was the existence of insulin resistance but not its severity, which could partly explain the results of the study by Akavan-Khaleghi et al ( 6 ).…”

“…Akavan-Khaleghi et al ( 6 ) in this issue of the journal title provided a new piece of information regarding the influence of insulin resistance on LV longitudinal deformation. The authors reported no difference in LV global longitudinal strain (GLS) and systolic and diastolic strain rates between participants with glycated hemoglobin (HbA1c) level <5.7% and 5.7%–6.4% ( 6 ).…”

Effects of Physical Exercise on Left Ventricular Function in Type 2 Diabetes Mellitus: A Systematic Review

“…IFG and normal HbA1c. 3 Estimates of the prevalence of left ventricular diastolic dysfunction (LVDD) in T2DM range from 23% to 54%. 4 Moreover, diabetes duration longer than four years was independently associated with LVDD -left ventricular diastolic filling pressure (E/e´ ratio) greater than 15 (normal value <8) -even after adjustment for age, gender, body mass index (BMI), prior CAD, prior systemic hypertension and LVEF.…”

High fructose intake may be related to carotid artery stenosis

“…The accompanying fiber which is metabolized as a part of a complete food naturally decelerates and modulates fructose release [6]. The overconsumption of either natural or refined fructose increases in recent years and this increase is believed to have a relation with some diseases such as insulin resistance, type-2 diabetes, hyperglycemia, cardiovascular diseases and especially obesity [7][8][9].…”