Impact of Myocardial Acceleration during Isovolumic Contraction in Evaluating Subclinical Right Ventricular Systolic Dysfunction in Type 2 Diabetes Mellitus Patients

Tayyareci, Yelda; Yurdakul, Selen; Tayyareci, Gülşah; Nişancí, Yílmaz; Umman, Berrin; Buğra, Zehra

doi:10.1111/j.1540-8175.2010.01237.x

Cited by 18 publications

(13 citation statements)

References 40 publications

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“…In this current study it was observed that the mean LVEF and mean RVFAC were almost alike between two groups.In this study it was observed that tricuspid inflow parameter (E/A ratio) were almost similar between two groups.Tayyareci 5 showed the similar changes .It indicates that conventional Doppler had failed to detect RV diastolic dysfunction .…”

Section: Discussionsupporting

confidence: 49%

“…[2][3][4] Diabetes mellitus has direct effects on the heart, independent of obstructive disease and hypertension and causes development of a specific cardiomyopathy. 5 Several studies using echocardiography have demonstrated deterioration in left ventricular diastolic properties in diabetic patients. [6][7][8][9] RV function has proven to be of importance for risk stratification in heart failure and is associated with sudden death and exercise limitation .…”

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confidence: 99%

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Early Detection of Right Ventricular Dysfunction by Myocardial Performance Index in Diabetic Patients

et al. 2015

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Introduction :Diabetes mellitus is one of the most common endocrine disorders. The incidence of diabetes mellitus is continuously increasing and about 90% of patients of diabetes mellitus have type 2 diabetes mellitus . 1 Reports from the Framingham study and other studies have established diabetes as a strong risk factor for cardiovascular morbidity and mortality. [2][3][4] Diabetes mellitus has direct effects on the heart, independent of obstructive disease and hypertension and causes development of a specific cardiomyopathy. 5 Several studies using echocardiography have demonstrated deterioration in left ventricular diastolic properties in diabetic patients. [6][7][8][9] RV function has proven to be of importance for risk stratification in heart failure and is associated with sudden death and exercise limitation . 10 RV function has not been studied in depth yet in diabetic patients although the RV has an important contribution to the overall cardiac function . 11 RV dysfunction especially diastolic dysfunction may play a role in diabetic cardiomyopathy. 10 The majority of proposed methods of echocardiographic assessment of RV function are based on volumetric approximations of RV .Such approaches have inherent limitations ,first as volume related measures such as ejection fraction (EF) are load dependant; second because of the complex geometry of RV . 12 The issue of RV geometry is usually overcome using geometry -independent parameters such as tricuspid annular velocity and MPI .MPI is calculated using Doppler as the ratio of the isovolumic contraction and relaxation times to the ejection time which encompasses both systolic and diastolic functions. 13 In systolic dysfunction ,the isovolumic contraction time increases ,whereas the ejection time decreases and ,consequently , the MPI increases. In diastolic dysfunction, there is prolongation of isovolumic relaxation time that also results in an increased MPI .Tei et al. 14 proposed a Tei index (or myocardial performance index ) ,obtained from Doppler time intervals, which allows simple noninvasive and nongeometric estimation of global ventricular functions. It has been found to have prognostic value for various cardiac conditions .Yeo et al. 15 reported Doppler right ventricular index to be a useful noninvasive parameter that correlates with symptoms and survival in patients with pulmonary hypertension .Data regarding RV performance in patients with diabetes are incomplete. Some studies have been shown right ventricular dysfunction. Myocardial dysfunction in patients with diabetes mellitus is not confined to the left ventricle, but also involves the right ventricle, and the impairment of RV function encompasses both systolic and diastolic abnormalities. Abstract:In diabetes mellitus (DM) patients, left ventricular dysfunction is widely evaluated and established by conventional diagnostic methods, whereas right ventricular (RV) function is not sufficiently evaluated. The aim of this study was to assess the right ventricular function in type 2 diabetic patients...

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Section: Discussionsupporting

confidence: 49%

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confidence: 99%

Early Detection of Right Ventricular Dysfunction by Myocardial Performance Index in Diabetic Patients

et al. 2015

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“…Previous studies reporting on impaired RV diastolic function in diabetic patients (13–17) were limited by the inclusion of patients with diabetes-related cardiovascular complications and/or inclusion of type 1 diabetic patients. None of these studies has evaluated RV volumes to study geometrical changes of the right ventricle in diabetes.…”

Section: Discussionmentioning

confidence: 99%

“…Whereas animal studies have shown that dysfunction of the right ventricle might play a role in diabetic cardiomyopathy (12), the right ventricle is largely overlooked in human studies. Only a few echocardiographic studies discuss the right ventricle in diabetes (13–17). These studies were limited by inclusion of patients with cardiovascular diabetes-related complications (13–15,17), and study populations consisted partially (13,14) or entirely of type 1 diabetic patients (16).…”

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confidence: 99%

Right Ventricular Involvement in Diabetic Cardiomyopathy

et al. 2013

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OBJECTIVETo compare magnetic resonance imaging-derived right ventricular (RV) dimensions and function between men with type 2 diabetes and healthy subjects, and to relate these parameters to left ventricular (LV) dimensions and function.RESEARCH DESIGN AND METHODSRV and LV volumes and functions were assessed in 78 men with uncomplicated type 2 diabetes and 28 healthy men within the same range of age using magnetic resonance imaging. Steady-state free precession sequences were used to assess ventricular dimensions. Flow velocity mapping across the pulmonary valve and tricuspid valve was used to assess RV outflow and diastolic filling patterns, respectively. Univariate general linear models were used for statistical analyses.RESULTSRV end-diastolic volume was significantly decreased in patients compared with healthy subjects after adjustment for BMI and pulse pressure (177 ± 28 mL vs. 197 ± 47 mL, P < 0.01). RV systolic function was impaired: peak ejection rate across the pulmonary valve was decreased (433 ± 54 mL/s vs. 463 ± 71 mL/s, P < 0.01) and pulmonary flow acceleration time was longer (124 ± 17 ms vs. 115 ± 25 ms, P < 0.05). Indexes of RV diastolic function were impaired: peak filling rate and peak deceleration gradient of the early filling phase were 315 ± 63 mL/s vs. 356 ± 90 mL/s (P < 0.01) and 2.3 ± 0.8 mL/s2 × 10−3 vs. 2.8 ± 0.8 mL/s2 × 10−3 (P < 0.01), respectively. All RV parameters were strongly associated with its corresponding LV parameter (P < 0.001).CONCLUSIONSDiabetic cardiomyopathy affects the right ventricle, as demonstrated by RV remodeling and impaired systolic and diastolic functions in men with type 2 diabetes, in a similar manner as changes in LV dimensions and functions. These observations suggest that RV impairment might be a component of the diabetic cardiomyopathy phenotype.

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“…Tayyareci et al [16] demonstrated subclinic right ventricular dysfunction in patients with type 2 DM by using IVA. Thirty-two patients in our study had impaired IVA values.…”

Section: Discussionmentioning

confidence: 99%

The effects of urgent percutaneous coronary intervention on right ventricular systolic functions in non-ST-elevation acute coronary syndromes

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et al. 2015

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Abstract:Background: Although the importance of the right ventricle (RV) involvement has been known for many years in patients with ST-elevation myocardial infarction (STEMI), it is scarce in non-ST-elevation acute coronary syndrome (NSTE-ACS). Objectives: We aimed to investigate the eff ects of urgent percutaneous coronary intervention (PCI) on the RV systolic functions in patients with NSTE-ACS. Materials and Methods: Ninety-fi ve patients diagnosed with NSTE-ACS and who underwent urgent PCI were prospectively investigated. RV systolic functions were analyzed and compared before and after PCI in all patients by using RV index of myocardial performance (RIMP), tricuspid annular plane systolic excursion (TAPSE), two-dimensional (2D) RV fractional area change (FAC), and isovolumic acceleration (IVA) parameters with transthoracic echocardiography. Results: Among 95 NSTE-ACS patients, 31 had impaired RIMP, 13 had impaired TAPSE, 8 had decreased 2D FAC, and 32 had impaired IVA values at baseline. There was a signifi cant increase in 2D FAC and IVA values after PCI. Conclusions: The right ventricular functions may also be aff ected in patients with NSTE-ACS, and urgent PCI has a signifi cant eff ect on the recovery of right ventricular systolic functions in patients with NSTE-ACS.

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Impact of Myocardial Acceleration during Isovolumic Contraction in Evaluating Subclinical Right Ventricular Systolic Dysfunction in Type 2 Diabetes Mellitus Patients

Abstract: Diabetes is associated with subclinical RV systolic dysfunction, regardless of coexisting hypertension. Tissue Doppler-derived IVA; is a novel, non-invasive parameter which may be used in early detection of RV systolic dysfunction in patients with DM.

Cited by 18 publications

References 40 publications

Early Detection of Right Ventricular Dysfunction by Myocardial Performance Index in Diabetic Patients

Early Detection of Right Ventricular Dysfunction by Myocardial Performance Index in Diabetic Patients

Right Ventricular Involvement in Diabetic Cardiomyopathy

The effects of urgent percutaneous coronary intervention on right ventricular systolic functions in non-ST-elevation acute coronary syndromes

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