Left ventricular metabolic remodeling and accompanied dysfunction in type 2 diabetic patients: A 3D speckle tracking analysis

Wang, Qingqing; Tan, Kaibin; Xia, Hongmei; Gao, Yunhua

doi:10.1111/echo.14248

Cited by 7 publications

(10 citation statements)

References 23 publications

(33 reference statements)

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“…For example, the measured 3D global longitudinal strain (GLS) of controls in some studies 14 is worse than measured 3D GLS of patients with diabetes mellitus in some other studies. 10 , 13 , 21 Furthermore, it is unclear which direction has the largest difference between patients with diabetes mellitus and controls, and whether there are any significant differences between vendors in measured strain values in these studies.…”

mentioning

confidence: 89%

“…Some studies have aimed to assess the effects of diabetes mellitus on cardiac function using 3D‐STE. 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 Most of these studies reported worse myocardial deformation indexes in patients with diabetes mellitus compared with healthy controls. However, the data are not robust and somewhat heterogeneous among studies.…”

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confidence: 99%

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Three‐Dimensional Global Left Ventricular Myocardial Strain Reduced in All Directions in Subclinical Diabetic Cardiomyopathy: A Systematic Review and Meta‐Analysis

Ghoreyshi-Hefzabad

Jeyaprakash

Gupta

et al. 2021

JAHA

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Background Three‐dimensional (3D) speckle tracking echocardiography can identify subclinical diabetic cardiomyopathy without geometric assumption and loss of speckle from out‐of‐plane motions. There is, however, significant heterogeneity among the previous reports. We performed a systematic review and meta‐analysis to compare 3D strain values between adults with asymptomatic, subclinical diabetes mellitus (ie, patients with diabetes mellitus without known clinical manifestations of cardiac disease) and healthy controls. Methods and Results After systematic review of 5 databases, 12 valid studies (544 patients with diabetes mellitus and 489 controls) were eligible for meta‐analysis. Pooled means and mean difference (MD) using a random‐effects model for 3D global longitudinal, circumferential, radial, and area strain were calculated. Patients with diabetes mellitus had an overall 2.31 percentage points lower 3D global longitudinal strain than healthy subjects (16.6%, 95% CI, 15.7–17.6 versus 19.0; 95% CI, 18.2–19.7; MD, −2.31, 95% CI, −2.72 to −2.03). Similarly, 3D global circumferential strain (18.9%; 95% CI, 17.5–20.3 versus 20.5; 95% CI, 18.9–22.1; MD, −1.50; 95% CI, −2.09 to −0.91); 3D global radial strain (44.6%; 95% CI, 40.2–49.1 versus 48.2; 95% CI, 44.7–51.8; MD, −3.47; 95% CI, −4.98 to −1.97), and 3D global area strain (30.5%; 95% CI, 29.2–31.8 versus 32.4; 95% CI, 30.5–34.3; MD, −1.76; 95% CI, −2.74 to −0.78) were also lower in patients with diabetes mellitus. Significant heterogeneity was noted between studies for all strain directions (inconsistency factor [I 2 ], 37%–78%). Meta‐regression in subgroup analysis of studies using the most popular vendor found higher prevalence of hypertension as a significant contributor to worse 3D global longitudinal strain. Higher hemoglobulin A 1c was the most significant contributor to worse 3D global circumferential strain in patients with diabetes mellitus. Conclusions Three‐dimensional myocardial strain was reduced in all directions in asymptomatic diabetic patients. Hypertension and hemoglobin A 1c were associated with worse 3D global longitudinal strain and 3D global circumferential strain, respectively. Registration URL: https://www.crd.york.ac.uk/prospero ; unique identifier: CRD42020197825.

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confidence: 89%

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confidence: 99%

Three‐Dimensional Global Left Ventricular Myocardial Strain Reduced in All Directions in Subclinical Diabetic Cardiomyopathy: A Systematic Review and Meta‐Analysis

Ghoreyshi-Hefzabad

Jeyaprakash

Gupta

et al. 2021

JAHA

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“…The VR is found in hypertension, myocardial infarction (MI), and heart failure (HF) [3–5]. It can also be found in diabetic cardiomyopathy (DCM) and the antineoplastic drug-induced cardiotoxicity (CTX) [6,7]. A study has also shown that disease-induced VR is a complex process involving cardiomyocyte growth and death, vascular sparseness, fibrosis, inflammation, and electrophysiological remodeling [8].…”

Section: Ventricular Remodelingmentioning

confidence: 99%

The microRNA in ventricular remodeling: the miR-30 family

Zhang

Dong²,

Jia

et al. 2019

Bioscience Reports

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Ventricular remodeling (VR) is a complex pathological process of cardiomyocyte apoptosis, cardiac hypertrophy, and myocardial fibrosis, which is often caused by various cardiovascular diseases (CVDs) such as hypertension, acute myocardial infarction, heart failure (HF), etc. It is also an independent risk factor for a variety of CVDs, which will eventually to damage the heart function, promote cardiovascular events, and lead to an increase in mortality. MicroRNAs (miRNAs) can participate in a variety of CVDs through post-transcriptional regulation of target gene proteins. Among them, microRNA-30 (miR-30) is one of the most abundant miRNAs in the heart. In recent years, the study found that the miR-30 family can participate in VR through a variety of mechanisms, including autophagy, apoptosis, oxidative stress, and inflammation. VR is commonly found in ischemic heart disease (IHD), hypertensive heart disease (HHD), diabetic cardiomyopathy (DCM), antineoplastic drug cardiotoxicity (CTX), and other CVDs. Therefore, we will review the relevant mechanisms of the miR-30 in VR induced by various diseases.

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“…According to the historical definition of > 15% increase in left ventricular end-systolic volume (LVESV), LVR is observed in as many as 30% of anterior myocardial infarction (MI) cases and approximately 17% of non-anterior MI cases even with timely primary coronary intervention (PCI) and the use of cardiovascular-protective drugs such as angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers, beta blockers, mineral corticoid receptor antagonists, and statins [ 4 ]. Diabetes alone is known to cause LVR [ 5 , 6 ], and in another concept of diabetes mellitus-related cardiomyopathy (DMCMP), LVR has no other cause besides DM [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of clinical outcomes and left ventricular remodeling after ST-elevation myocardial infarction between patients with and without diabetes mellitus

et al. 2021

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Left ventricular remodeling (LVR) after ST-elevation myocardial infarction (STEMI) is generally thought to be an adaptive but compromising phenomenon particularly in patients with diabetes mellitus (DM). However, whether the extent of LVR is associated with poor prognostic outcome with or without DM after STEMI in the modern era of reperfusion therapy has not been elucidated. This was a single-center retrospective observational study. Altogether, 243 patients who were diagnosed as having STEMI between January 2016 and March 2019, and examined with echocardiography at baseline (at the time of index admission) and mid-term (from 6 to 11 months after index admission) follow-up were included and divided into the DM (n = 98) and non-DM groups (n = 145). The primary outcome was major adverse cardiovascular events (MACEs) defined as the composite of all-cause death, heart failure (HF) hospitalization, and non-fatal myocardial infarction. The median follow-up duration was 621 days (interquartile range: 304–963 days). The DM group was significantly increased the rate of MACEs (P = 0.020) and HF hospitalization (P = 0.037) compared with the non-DM group, despite of less LVR. Multivariate Cox regression analyses revealed that the patients with DM after STEMI were significantly associated with MACEs (Hazard ratio [HR] 2.79, 95% confidence interval [CI] 1.20–6.47, P = 0.017) and HF hospitalization (HR 3.62, 95% CI 1.19–11.02, P = 0.023) after controlling known clinical risk factors. LVR were also significantly associated with MACEs (HR 2.44, 95% CI 1.03–5.78, P = 0.044) and HF hospitalization (HR 3.76, 95% CI 1.15–12.32, P = 0.029). The patients with both DM and LVR had worse clinical outcomes including MACEs and HF hospitalization, suggesting that it is particularly critical to minimize LVR after STEMI in patients with DM.

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Left ventricular metabolic remodeling and accompanied dysfunction in type 2 diabetic patients: A 3D speckle tracking analysis

Cited by 7 publications

References 23 publications

Three‐Dimensional Global Left Ventricular Myocardial Strain Reduced in All Directions in Subclinical Diabetic Cardiomyopathy: A Systematic Review and Meta‐Analysis

Three‐Dimensional Global Left Ventricular Myocardial Strain Reduced in All Directions in Subclinical Diabetic Cardiomyopathy: A Systematic Review and Meta‐Analysis

The microRNA in ventricular remodeling: the miR-30 family

Comparison of clinical outcomes and left ventricular remodeling after ST-elevation myocardial infarction between patients with and without diabetes mellitus

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