Andova Valentina, Georgievska-Ismail Ljubica, Srbinovska Elizabeta, Janeska Biljana
University Clinic of Cardiology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia.
Institute of Forensic Medicine, Criminalistic and Deontology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia.
Open Access Maced J Med Sci. 2018 Nov 20;6(11):2084-2090. doi: 10.3889/oamjms.2018.452. eCollection 2018 Nov 25.
Coronary artery disease (CAD) is the leading cause of mortality and morbidity in patients with diabetes (DM).
The aim of our study was to analyse the ability of pharmacological SE to risk stratify patients with DM using qualitative and quantitative assessment of LV function.
We prospectively assessed 105 consecutive patients (58.7 ± 9.5 y, 39 male) with known or suspected CAD who underwent dipyridamole or dobutamine SE.
Change of systolic LV function at maximal SE was less pronounced in patients with DM, while parameters of the diastolic function and its change with stress were almost insignificant. WMSI in comparison to GLS% didn't make a difference in SE outcome regarding DM presence. WMSI was almost unchanged at maximal stress in diabetic patients. Conversely, GLS% showed significant worsening at maximal stress in diabetic patients. However, only WMSI at maximal stress along with DM presence appeared as independent predictors of the presence of new and worsening CAD during SE. Longitudinal strain assessed using speckle tracking during pharmacological stress echocardiography was superior to conventional echocardiography expressed by wall motion analysis in making a difference regarding DM presence.
We confirmed the usefulness of stress echocardiography using qualitative and/or quantitative parameters in the detection of CAD in patients with DM.
冠状动脉疾病（CAD）是糖尿病（DM）患者死亡和发病的主要原因。
我们研究的目的是通过对左心室功能进行定性和定量评估，分析药物负荷超声心动图（SE）对糖尿病患者进行危险分层的能力。
我们前瞻性评估了105例连续的已知或疑似CAD患者（年龄58.7±9.5岁，男性39例），这些患者接受了双嘧达莫或多巴酚丁胺负荷超声心动图检查。
糖尿病患者在最大负荷超声心动图时左心室收缩功能的变化不太明显，而舒张功能参数及其应激变化几乎不显著。与整体纵向应变率（GLS%）相比，心肌运动评分指数（WMSI）在负荷超声心动图结果方面对糖尿病的存在没有差异。糖尿病患者在最大应激时WMSI几乎不变。相反，糖尿病患者在最大应激时GLS%显著恶化。然而，只有最大应激时的WMSI以及糖尿病的存在似乎是负荷超声心动图期间新发和恶化CAD存在的独立预测因素。在药物负荷超声心动图期间使用斑点追踪评估的纵向应变在区分糖尿病的存在方面优于通过壁运动分析表示的传统超声心动图。
我们证实了使用定性和/或定量参数的负荷超声心动图在检测糖尿病患者CAD中的有用性。
