Cardiology Department, Faculty of Medicine, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Dr. Erkin street, 34722, Istanbul, Turkey.
Cardiology Department, Adiyaman Training Ve Research Hospital, Yunus Emre Mahallesi, 1164 Sokak No: 13, Merkez/Adıyaman, Turkey.
Int J Cardiovasc Imaging. 2021 Feb;37(2):539-546. doi: 10.1007/s10554-020-02037-7. Epub 2020 Sep 20.
Myocardial tissue is sensitive to insulin resistance (IR) due to its interactions with insulin levels. Previous studies demonstrated that heart failure prevalence was higher in IR patients. Evaluation of myocardial deformation by multilayer global longitudinal strain (MGLS) might provide more information about IR related left ventricular dysfunction. In this study, we aimed to investigate subclinical LV dysfunction with MGLS in patients with IR. The study was designed as a prospective cross-sectional study. The present study included 64 patients with IR (+), and 54 subjects without IR (-) prospectively. The homeostasis model of insulin resistance (HOMA-IR) was used to quantify insulin resistance. Specific analysis for endocardial, mid-myocardial and epicardial layers were performed by two-dimensional (2D) speckle tracking echocardiography (STE) for multilayer global longitudinal strain. MGLS (Endocard-Mid-myocard-Epicard) values were significantly lower in the IR (+) group compared to IR (-) group ((GLS-endocard; - 15.1 ± 1.5 vs. - 18.7 ± 1.3, p < 0.001), (GLS-mid-myocard; - 16.0 ± 2.0 vs. - 18.0 ± 2.0, p < 0.001), (GLS-epicard; - 17.0 ± 1.7 vs. - 18.01 ± 1.94, p = 0.004)). GLS-endocard levels were significantly and positively correlated with HOMA-IR levels (r = 0.643, p < 0.001). HOMA-IR and age were found to be independent factors in detecting a decrease in GLS-endocard level in regression analysis. In conclusion, our data reveal that IR (+) patients had significantly lower strain values compared to IR (-) group. Besides, we presented that the HOMA-IR value was an independent predictor of subclinical left ventricular dysfunction.
心肌组织对胰岛素抵抗（IR）敏感，因为它与胰岛素水平相互作用。先前的研究表明，IR 患者的心力衰竭患病率更高。通过多层整体纵向应变（MGLS）评估心肌变形可能提供更多关于与 IR 相关的左心室功能障碍的信息。在这项研究中，我们旨在研究 IR 患者的 MGLS 检测到的亚临床 LV 功能障碍。该研究设计为前瞻性横断面研究。本研究包括 64 名 IR（+）患者和 54 名无 IR（-）患者。采用稳态模型胰岛素抵抗（HOMA-IR）定量胰岛素抵抗。通过二维（2D）斑点追踪超声心动图（STE）对心内膜、心肌中层和心外膜层进行特定分析，用于多层整体纵向应变。与 IR（-）组相比，IR（+）组的 MGLS（心内膜-心肌中层-心外膜）值明显更低（（GLS-心内膜；-15.1±1.5 比-18.7±1.3，p<0.001），（GLS-心肌中层；-16.0±2.0 比-18.0±2.0，p<0.001），（GLS-心外膜；-17.0±1.7 比-18.01±1.94，p=0.004））。GLS-心内膜水平与 HOMA-IR 水平呈显著正相关（r=0.643，p<0.001）。在回归分析中，发现 HOMA-IR 和年龄是检测 GLS-心内膜水平下降的独立因素。总之，我们的数据表明，与 IR（-）组相比，IR（+）患者的应变值明显更低。此外，我们提出 HOMA-IR 值是亚临床左心室功能障碍的独立预测因子。
