Fonseca Carissa G, Dissanayake Ajith M, Doughty Robert N, Whalley Gillian A, Gamble Greg D, Cowan Brett R, Occleshaw Christopher J, Young Alistair A
Department of Anatomy with Radiology, Faculty of Medical and Health Sciences, University of Auckland, New Zealand.
Am J Cardiol. 2004 Dec 1;94(11):1391-5. doi: 10.1016/j.amjcard.2004.07.143.
Left ventricular (LV) diastolic dysfunction often occurs in patients with type 2 diabetes mellitus (DM) independent of atherosclerotic coronary artery disease, myocardial ischemia, and regional wall motion anomalies. Limited information exists on LV myocardial tissue strain in this patient group. We measured 3-dimensional (3-D) parameters of LV systolic and diastolic functions in 28 patients who had type 2 DM (age 33 to 70 years), standard echocardiographic evidence of LV diastolic dysfunction, and normal LV ejection fraction, and 31 normal control subjects (age 19 to 74 years) who had no evidence of cardiac disease, with multislice cine anatomic and tagged magnetic resonance imaging. Three-dimensional analysis of the resulting images showed that peak systolic mitral valve plane displacement was 12% smaller (p = 0.040) and peak diastolic mitral valve plane velocity was 21% lower (p = 0.008) in patients who had DM than in normal controls. Peak systolic circumferential and longitudinal strains and principal 3-D shortening strain were 14%, 22%, and 10% smaller, respectively, in the DM group (p <0.001 for each). Peak diastolic rate of relaxation of circumferential and longitudinal strains and principal 3-D shortening strain were 35%, 32%, and 33% lower, respectively, in the DM group (p <0.001 for each). Thus, LV systolic circumferential, longitudinal and 3-D principal strains, and diastolic strain rates are impaired in patients who have type 2 DM, LV diastolic dysfunction, and normal LV ejection fraction.
左心室（LV）舒张功能障碍常发生于2型糖尿病（DM）患者中，与动脉粥样硬化性冠状动脉疾病、心肌缺血及局部室壁运动异常无关。关于该患者群体左心室心肌组织应变的信息有限。我们采用多层电影解剖及标记磁共振成像技术，测量了28例2型糖尿病患者（年龄33至70岁，有左心室舒张功能障碍的标准超声心动图证据且左心室射血分数正常）及31例无心脏病证据的正常对照者（年龄19至74岁）的左心室收缩和舒张功能的三维（3 - D）参数。对所得图像的三维分析显示，糖尿病患者的收缩期二尖瓣平面峰值位移比正常对照者小12%（p = 0.040），舒张期二尖瓣平面峰值速度低21%（p = 0.008）。糖尿病组的收缩期圆周应变、纵向应变及三维主缩短应变峰值分别小14%、22%和10%（各p <0.001）。糖尿病组的圆周应变、纵向应变及三维主缩短应变的舒张期峰值松弛率分别低35%、32%和33%（各p <0.001）。因此，2型糖尿病、左心室舒张功能障碍且左心室射血分数正常的患者，其左心室收缩期圆周、纵向及三维主应变以及舒张期应变率均受损。
