Aslan Abdullah Nabi, Ayhan Hüseyin, Çiçek Ömer Faruk, Akçay Murat, Durmaz Tahir, Keles Telat, Çakır Bekir, Bozkurt Engin
Department of Cardiology, Ankara Ataturk Education and Research Hospital, Turkey.
Intern Med. 2014;53(14):1477-84. doi: 10.2169/internalmedicine.53.1720. Epub 2014 Jul 15.
Several studies have shown that arterial stiffness and ventricular dysfunction are increased in individuals with type 2 diabetes. Aortic stiffness (AS) reflects the mechanical tension and elasticity of the aorta, and increased aortic stiffness is a risk factor for cardiovascular disease. The aim of this study was to evaluate the degree of aortic stiffness and its relationship with the left ventricular (LV) function in patients with prediabetes and healthy control subjects.
The study groups were composed of 50 patients with prediabetes and 47 healthy adults with similar demographic characteristics. The LV systolic and diastolic functions were assessed using standard two dimensional (2D) echocardiography, M-mode echocardiography, pulsed-wave (PW) echocardiography and tissue Doppler echocardiography. The degree of aortic strain and distensibility were calculated based on the aortic diameters measured on M-mode echocardiography at a level 3 cm above the aortic valve and the blood pressure values obtained on sphygmomanometry.
There were significant differences between the prediabetic and control groups in the degree of aortic strain (4.7 ± 2.8% vs. 14.9 ± 4.5%; respectively, p<0.001) and distensibility (2.0 ± 1.5 vs. 6.8 ± 2.3; 10(-3) cm(2) dyn(-1), respectively, p<0.001). In addition, significant differences were observed between the patient and control groups in the parameters of the LV systolic and diastolic functions. The left atrial diameter was significantly larger in the prediabetics than in the controls (35.9 ± 3.9 vs. 33.7 ± 4.2; respectively, p=0.027).
AS is increased in patients with prediabetes. In addition, there is a significant relationship between the degree of aortic stiffness and the LV function in this patient population. Therefore, the aortic elasticity parameters calculated on 2D echocardiography are useful for predicting early cardiovascular risks in prediabetics.
多项研究表明,2型糖尿病患者的动脉僵硬度和心室功能障碍会增加。主动脉僵硬度(AS)反映了主动脉的机械张力和弹性,主动脉僵硬度增加是心血管疾病的一个危险因素。本研究的目的是评估糖尿病前期患者和健康对照者的主动脉僵硬度程度及其与左心室(LV)功能的关系。
研究组由50例糖尿病前期患者和47例具有相似人口统计学特征的健康成年人组成。使用标准二维(2D)超声心动图、M型超声心动图、脉冲波(PW)超声心动图和组织多普勒超声心动图评估左心室的收缩和舒张功能。根据在主动脉瓣上方3 cm处通过M型超声心动图测量的主动脉直径和通过血压计获得的血压值计算主动脉应变和扩张性程度。
糖尿病前期组和对照组在主动脉应变程度(分别为4.7±2.8%和14.9±4.5%;p<0.001)和扩张性(分别为2.0±1.5和6.8±2.3;10(-3) cm(2) dyn(-1),p<0.001)方面存在显著差异。此外,患者组和对照组在左心室收缩和舒张功能参数方面也观察到显著差异。糖尿病前期患者的左心房直径明显大于对照组(分别为35.9±3.9和33.7±4.2;p=0.027)。
糖尿病前期患者的主动脉僵硬度增加。此外,在该患者群体中,主动脉僵硬度程度与左心室功能之间存在显著关系。因此,通过二维超声心动图计算的主动脉弹性参数有助于预测糖尿病前期患者的早期心血管风险。