Quantitative Analysis of Myocardial Work by Non-invasive Left Ventricular Pressure-Strain Loop in Patients With Type 2 Diabetes Mellitus

Abstract

Background: Type 2 diabetes mellitus (T2DM) is a common risk factor for cardiovascular diseases. The aims of this study were to evaluate the changes in the left ventricular myocardial work in T2DM patients using the left ventricular pressure-strain loop (PSL) technique, and to explore the risk factors for the left ventricular myocardial work impairment.Methods: Fifty patients with T2DM and 50 normal controls (NCs) were included in the study. In addition to conventional echocardiography and two-dimensional speckle tracking echocardiography, the left ventricular myocardial work parameters were measured using PSL technology.Results: The absolute value for global longitudinal strain (GLS), global work index (GWI) and, global constructive work (GCW) were significantly decreased in the T2DM group (P < 0.05), while the left ventricular ejection fraction (LVEF) was not significantly different between the T2DM and NC groups. Multivariable linear regression analysis showed that hemoglobin A1c (HbA1c) was independently related to GWI (β = −0.452, P < 0.05), while HbA1c and the diabetes duration were independently related to GCW (β = −0.393, P < 0.05 and β = −0.298, P < 0.05, respectively).Conclusions: Changes in the left ventricular myocardial systolic function in T2DM patients were identified using PSL technology. HbA1c was shown to be an independent risk factor affecting GWI, while HbA1c and diabetes duration were demonstrated to be independent risk factors affecting GCW.

Quantitative assessment of left ventricular myocardial work in patients with different types of atrial fibrillation by non‐invasive pressure‐strain loop technique

“…This technique involves a combined analysis of LV GLS and brachial artery blood pressure, which overcomes the load dependence of LVEF and GLS and can more accurately assess myocardial work capacity. Previous studies have demonstrated that noninvasive myocardial work can help with the early assessment of myocardial damage among patients with hypertension, cardiomyopathy, and coronary artery disease, 18 patients undergoing synchronized therapy (CRT), 19 and those with myocardial amyloidosis, 20 systemic lupus erythematosus, 21 type 2 diabetes mellitus, 22 renal insufficiency 23 and other diseases. In this study, although the LVEF of the AF and control groups did not differ significantly, the MW parameters differed.…”

Clinical research progress of myocardial work in assessment and prediction of coronary artery disease in noninvasive pressure‐strain loop technique

“…42 Resting GWE value is closely related to LV systolic reserve and exercise capacity, and GWE during exercise is an independent predictor of significant LV systolic reserve. 60 Therefore, PSL may also have an evaluation and prediction role in some diseases that can cause LV dysfunction, [61][62][63][64][65] especially in chronic kidney disease. 66,67 Newly developed quantitative PSL technology provides a new method for clinical research to assess myocardial function.…”

Subclinical left ventricular myocardial dysfunction in patients with obstructive sleep apnea syndrome: insights from noninvasive left ventricular myocardial work analysis

“…These changes consequently lead to the deterioration of myocardial energy exploitation and metabolic activity, which may explain the reduction of GWI and GCW. Huang et al found that GWI and GCW were lower in patients with diabetes mellitus after adjusting for blood pressure and clinical parameters [ 36 ]. Moreover, GWI and GCW were reportedly higher in patients with Turner syndrome than in healthy individuals even though blood pressure and GLS were not significantly different [ 37 ].…”