Nahar S, Ahmed C M, Shakil S S
Dr Samsun Nahar, Junior Consultant (Cardiology), United Hospital Ltd, Dhaka, Bangladesh; E-mail:
Mymensingh Med J. 2019 Apr;28(2):370-377.
Left ventricular dysfunction in diabetes mellitus (DM) patients is widely assessed and established by conventional diagnostic methods, whereas right ventricular (RV) function is not sufficiently evaluated. The aim of this study was to assess the right ventricular function in type 2 diabetic patients In this case control study, forty nine (49) diabetic patients and same number of (49) non-diabetic healthy volunteers were studied who were devoid of any other conditions that may influence the both systolic and diastolic function of the RV. In addition to 2D and M-mode evaluation, standard Doppler, pulsed tissue Doppler and 3D echocardiographic assessment of both ventricles were performed. Both right ventricular (RV) systolic and diastolic parameters were impaired in tissue Doppler analysis. Tissue Doppler derived IVA was significantly (p<0.05) lower in diabetic patients. Right ventricular early diastolic velocity (E') and late diastolic velocity (A'), E'/A' were significantly (p<0.05) lower in DM. MPI and E/E' was significantly (p<0.05) higher in diabetic patients. The RV parameters (E/E', IVA, MPI) showed positive relation with the LV similar parameters in tissue Doppler assessment. Diabetes is associated with both RV systolic and diastolic dysfunction. Pulsed tissue Doppler is a useful tool to detect the early changes. RV parameters (both systolic and diastolic) correlate well with those of the LV.
糖尿病（DM）患者的左心室功能障碍已通过传统诊断方法得到广泛评估和确认，而右心室（RV）功能尚未得到充分评估。本研究的目的是评估2型糖尿病患者的右心室功能。在这项病例对照研究中，对49名糖尿病患者和同样数量（49名）的非糖尿病健康志愿者进行了研究，这些志愿者没有任何可能影响右心室收缩和舒张功能的其他疾病。除了二维和M型评估外，还对两个心室进行了标准多普勒、脉冲组织多普勒和三维超声心动图评估。在组织多普勒分析中，右心室（RV）的收缩和舒张参数均受损。糖尿病患者组织多普勒得出的等容加速时间（IVA）显著降低（p<0.05）。糖尿病患者右心室舒张早期速度（E'）和舒张晚期速度（A'）、E'/A'显著降低（p<0.05）。糖尿病患者的心肌做功指数（MPI）和E/E'显著升高（p<0.05）。在组织多普勒评估中，右心室参数（E/E'、IVA、MPI）与左心室类似参数呈正相关。糖尿病与右心室收缩和舒张功能障碍均有关。脉冲组织多普勒是检测早期变化的有用工具。右心室参数（收缩和舒张）与左心室参数密切相关。
