Tadic Marijana, Celic Vera, Cuspidi Cesare, Ilic Sanja, Pencic Biljana, Radojkovic Jana, Ivanovic Branislava, Stanisavljevic Dejana, Kocabay Gonenc, Marjanovic Tamara
Department of Cardiology, University Clinical Hospital Center "Dr Dragisa Misovic - Dedinje," Belgrade, Serbia.
Department of Cardiology, University Clinical Hospital Center "Dr Dragisa Misovic - Dedinje," Belgrade, Serbia; Faculty of Medicine, Belgrade, Serbia.
J Am Soc Echocardiogr. 2015 Mar;28(3):317-27. doi: 10.1016/j.echo.2014.11.017. Epub 2015 Jan 2.
The aim of this study was to determine right ventricular (RV) and right atrial (RA) deformation assessed by two-dimensional echocardiographic and three-dimensional echocardiographic (3DE) imaging in patients with prediabetes and type 2 diabetes mellitus.
This cross-sectional study included 47 untreated normotensive subjects with prediabetes, 57 recently diagnosed normotensive patients with diabetes, and 54 healthy controls of similar sex and age distributions. All subjects underwent laboratory analyses and complete two-dimensional echocardiographic and 3DE examinations.
Three-dimensional echocardiographic RV end-diastolic volume index gradually decreased from controls across patients with diabetes to those with diabetes (69 ± 10 vs 63 ± 8 vs 58 ± 8 mL/m(2), P < .001), whereas 3DE RV end-systolic volume index was higher in controls compared with patients with diabetes and those with diabetes (25 ± 4 vs 23 ± 4 vs 22 ± 4 mL/m(2), P < .001). However, there was no difference in 3DE RV ejection fraction among the three groups (63 ± 4% vs 62 ± 4% vs 61 ± 5%, P = .063). RV and RA global strain and systolic and early diastolic strain rates were decreased in patients with prediabetes and in those with diabetes compared with controls, whereas RV and RA late diastolic strain rates were increased in these patients. Multivariate regression analysis showed that RV global strain was associated with glycated hemoglobin, independent of left ventricular parameters.
RV and RA myocardial deformation and function obtained by 3DE and two-dimensional echocardiographic strain, even in normal ranges, were decreased in patients with prediabetes and in those with diabetes compared with controls. The long-term parameter of glucose control was correlated with the right heart mechanics.
本研究旨在通过二维超声心动图和三维超声心动图（3DE）成像评估糖尿病前期和2型糖尿病患者的右心室（RV）和右心房（RA）变形情况。
这项横断面研究纳入了47名未经治疗的血压正常的糖尿病前期受试者、57名最近诊断出的血压正常的糖尿病患者以及54名性别和年龄分布相似的健康对照者。所有受试者均接受了实验室分析以及完整的二维超声心动图和3DE检查。
3DE右心室舒张末期容积指数从对照组到糖尿病前期患者再到糖尿病患者逐渐降低（69±10 vs 63±8 vs 58±8 mL/m²，P<.001），而3DE右心室收缩末期容积指数在对照组中高于糖尿病患者和糖尿病前期患者（25±4 vs 23±4 vs 22±4 mL/m²，P<.001）。然而，三组之间的3DE右心室射血分数没有差异（63±4% vs 62±4% vs 61±5%，P=.063）。与对照组相比，糖尿病前期患者和糖尿病患者的右心室和右心房整体应变以及收缩期和舒张早期应变率降低，而这些患者的右心室和右心房舒张晚期应变率升高。多变量回归分析表明，右心室整体应变与糖化血红蛋白相关，独立于左心室参数。
与对照组相比，糖尿病前期患者和糖尿病患者通过3DE和二维超声心动图应变获得的右心室和右心房心肌变形及功能即使在正常范围内也有所降低。血糖控制的长期参数与右心力学相关。
