Myocardial dysfunction identified by three-dimensional speckle tracking echocardiography in type 2 diabetes patients relates to complications of microangiopathy

Abstract

Diabetic microangiopathy and its accumulated effects significantly related to subclinical LV dysfunction are characterized by impaired longitudinal shortening.

Three‐dimensional speckle tracking echocardiography: Is it the magic wand in the diagnosis of subclinical myocardial dysfunction in children with type 1 diabetes mellitus?

“…Longitudinal strain impairment found to be one of the earliest sign of myocardial dysfunction in DM in several studies due to the effect of subendocardial damage caused by microvascular coronary ischemia. 14,24,25 Decreased 3D strains were significantly correlated with 4D-LV EF but not correlated with conventional 2D-LV EF denoting that decreased 3D-strains could be used in early detection of systolic myocardial dysfunction unlike conventional 2D-LV EF which is considered a late indictor for systolic dysfunction. 2D-S = two-dimensional strain; E′/A′ ratio = ratio of the early (E) to late (A) ventricular filling velocities by tissue Doppler imaging; EF = ejection fraction; FBG = fasting blood glucose.…”

“…showed that 2D longitudinal and radial functions of each LV segment were impaired in diabetic adult patients. Longitudinal strain impairment found to be one of the earliest sign of myocardial dysfunction in DM in several studies due to the effect of subendocardial damage caused by microvascular coronary ischemia …”

Independence of coronary artery disease to subclinical left ventricular dysfunction

“…Although there is a strong association between CAC and incident HF, only partly mitigated after adjustment for cardiovascular risk factors, 7,8 it seems likely that this reflects the contribution of overt CAD to HF. Previous studies suggesting a link between CAC and LV dysfunction were in patients with very high burdens of CAC (≥400), 9 greater severity of LV dysfunction measured by ejection fraction, 10,11 or high baseline risk, such as those with suspected CAD or known diabetes 12,13 . The role of CAD in the development of SBHF is unclear in the setting of early disease.…”

More than 10 years of speckle tracking echocardiography: Still a novel technique or a definite tool for clinical practice?

“…Moreover, in the early stages of the disease, torsional LV mechanic is found to be super-normal, as a compensation mechanism. 35 Furthermore, various correlations between LV-GLS and complications related to DM have been established 36,37 ; likewise, RV longitudinal function has found to be correlated to worse renal function in DM patients. 25 The deterioration of longitudinal function is also found in patients affected by diabetes mellitus (DM), 34 with a progressive worsening that follows the natural history of the disease.…”

“…25 The deterioration of longitudinal function is also found in patients affected by diabetes mellitus (DM), 34 with a progressive worsening that follows the natural history of the disease. 35 Furthermore, various correlations between LV-GLS and complications related to DM have been established 36,37 ; likewise, RV longitudinal function has found to be correlated to worse renal function in DM patients. 38 LA function is more impaired in DM than in AH, and its reduction is maximum in subjects with both diseases.…”