Left Ventricular Radial Systolic Dysfunction in Diabetic Patients Assessed by Myocardial Acceleration Derived From Velocity Vector Imaging

Abstract

Objectives The purpose of this study was to determine whether left ventricular (LV) radial systolic dysfunction occurred in diabetic patients with a normal left ventricular ejection fraction (LVEF) and impaired longitudinal contraction. Methods Velocity vector imaging was performed in 22 patients with type 2 diabetes without microangiopathy (12 men and 10 women; mean age ± SD, 49 ± 7 years), 21 patients with microangiopathy (12 men and 9 women; mean age, 50 ± 6 years), and 21 healthy control participants (11 men and 10 women; mean age, 49 ± 8 years). The groups were matched for age and sex. All had no clinical symptoms of heart disease, coronary artery disease, or hypertension. Results The LVEF, fractional shortening, and end‐diastolic diameter were statistically comparable in all groups. The left ventricular wall thickness was significantly greater in diabetic patients than controls (P < .05). Average peak early diastolic accelerations at all LV levels were significantly lower in diabetic patients than controls in the long‐and short‐axis directions (all P < .05). In the long‐axis direction, a significantly lower average peak isovolumic contraction acceleration was found at the mid and apical levels in patients without microangiopathy and at all LV levels in patients with microangiopathy than controls (all P < .05). In the short‐axis direction, a significantly lower average isovolumic contraction acceleration was found at the apical level in patients without microangiopathy and at the basal and apical levels in patients with microangiopathy (all P < .05). Conclusions In diabetic patients with a normal LVEF, myocardial systolic dysfunction occurs not only in the long‐axis direction but also in the short‐axis direction.

Subclinical Left Ventricular Longitudinal and Radial Systolic Dysfunction in Children and Adolescents with Type 1 Diabetes Mellitus

“…However, this inconsistency may be explained on the basis of the restrictive inclusion criteria as the patients in the aforementioned pediatric studies and also in our study were relatively younger with short duration of DM and no diabetic complications. Several studies have recently reported that isolated diastolic dysfunction is rare and is usually associated with subclinical systolic dysfunction . Different studies have demonstrated that subtle abnormalities in longitudinal function of the LV can be identified using tissue Doppler imaging and 2DSTE in adult diabetic patients with a normal LV ejection fraction .…”

Predictors and prevention of diabetic cardiomyopathy

“…The beta cells, due to their continued workload, die and thus, in the long-term, T2D leads to T1D (Figure 3). Diabetes is associated with structural (fibrosis,55,78 apoptosis,55,79,80 angiopathy81–83), functional (endothelium–myocytes uncoupling,55 impaired contractility of cardiomyocytes,75 decreased survival and differentiation of cardiac stem cells,31 diastolic and systolic dysfunction55,75,84,85), and regulatory (alteration in the levels of miRNAs29,30,86 and signaling molecules involved in glucose metabolism2,3,16,87) remodeling that leads to DCM (Figure 3). …”

Advanced Interfere Treatment of Diabetic Cardiomyopathy Rats by aFGF-Loaded Heparin-Modified Microbubbles and UTMD Technique

“…DCM results in cardiac functional and structural changes, independent of hypertension, coronary artery disease, or any other known cardiac disease. The structural changes include fibrosis, apoptosis, hypertrophy of myocytes and the functional changes include systolic and diastolic dysfunction [2][3][4][5][6][7]. DCM patients do not show special clinical symptoms in the early stage which makes it difficult for early clinical diagnosis and effective treatment.…”