Parsaee Mozhgan, Bahmanziari Parvaneh, Ardeshiri Maryam, Esmaeilzadeh Maryam
Rajaei Cardiovascular, Medical and Research Center, Tehran University of Medical Sciences, Tehran, Iran.
J Tehran Heart Cent. 2012 Nov;7(4):177-81. Epub 2012 Nov 30.
Diabetes mellitus is capable of impairing the myocardial function. Several studies have documented the influential impact of diabetes mellitus on the left ventricular function. The right ventricular function plays a significant role in the overall myocardial contractility; hence, this study was undertaken to evaluate the effect of diabetes mellitus type II on the right ventricular function.
Twenty-two diabetic patients without any coronary artery disease, hypertension, or left ventricular dysfunction were studied. The right ventricular end diastolic diameter, tricuspid plane systolic excursion, right ventricular inflow Doppler parameters, longitudinal myocardial velocities, and deformation indices from the basal and apical segments of the right ventricular free wall of the case group were measured. The control group consisted of 22 healthy individuals.
The tricuspid annular plane systolic excursion (TAPSE) and tricuspid peak early to peak late diastolic flow velocities ratio (E/A) in the diabetic patients were significantly lower than those of the control group patients (18.9 vs. 23.2, p value < 0.001 and 0.96 vs. 1.21, p value = 0.012), but there were no significant differences in the right ventricular end diastolic diameter and the right ventricular Tei index between the two groups (p value = 0.72). The right ventricular basal peak myocardial systolic velocity (SM) (12 cm/sec vs. 13.4 cm/sec; p value = 0.03), basal and apical right ventricular free wall systolic strain (-13.3% and -18.7% vs. -20.2% and -25.7%; p value = 0.001), and apical strain rate (-1.2 1/s vs. -1.6 1/s; p value = 0.008 ) were significantly lower in the study group. There was a weak correlation between the right ventricular function and HbA1c as well as the duration of diabetes mellitus and C-reactive protein.
Our results suggest that diabetes mellitus type II can influence the right ventricular function in the absence of coronary artery disease, diastolic dysfunction, and pulmonary hypertension.
糖尿病会损害心肌功能。多项研究记录了糖尿病对左心室功能的影响。右心室功能在整体心肌收缩力中起重要作用；因此，本研究旨在评估2型糖尿病对右心室功能的影响。
对22例无任何冠状动脉疾病、高血压或左心室功能障碍的糖尿病患者进行研究。测量病例组右心室舒张末期内径、三尖瓣环平面收缩期位移、右心室流入道多普勒参数、纵向心肌速度以及右心室游离壁基底段和心尖段的变形指数。对照组由22名健康个体组成。
糖尿病患者的三尖瓣环平面收缩期位移（TAPSE）和三尖瓣舒张早期峰值流速与舒张晚期峰值流速之比（E/A）显著低于对照组患者（18.9对23.2，p值<0.001；0.96对1.21，p值=0.012），但两组间右心室舒张末期内径和右心室Tei指数无显著差异（p值=0.72）。研究组右心室基底段心肌收缩期峰值速度（SM）（12cm/秒对13.4cm/秒；p值=0.03）、右心室游离壁基底段和心尖段收缩期应变（-13.3%和-18.7%对-20.2%和-25.7%；p值=0.001）以及心尖段应变率（-1.21/秒对-1.61/秒；p值=0.008）显著降低。右心室功能与糖化血红蛋白、糖尿病病程及C反应蛋白之间存在弱相关性。
我们的结果表明，在无冠状动脉疾病、舒张功能障碍和肺动脉高压的情况下，2型糖尿病会影响右心室功能。
