Department of Cardiology, West China Hospital of Sichuan University, 37 Guo Xue Xiang, Chengdu, 610041, China.
Department of Pediatric Surgery, West China Hospital of Sichuan University, Chengdu, 610041, China.
Sci Rep. 2020 Dec 8;10(1):21437. doi: 10.1038/s41598-020-78621-7.
Cardiovascular disease is one of the main causes of death in diabetes mellitus (DM) patients. The aim of the current study was to explore the value of peak strain dispersion (PSD) for discovering early-stage left ventricular (LV) dysfunction in type 2 diabetes mellitus (T2DM) patients. One hundred and one T2DM patients and sixty healthy subjects were selected for this study. T2DM patients were further divided into controlled blood glucose (HbA1c < 7%, n = 46) and uncontrolled blood glucose (HbA1c ≥ 7%, n = 55) subgroups. All participants underwent conventional echocardiography and two-dimensional speckle-tracking echocardiography. Our results showed that an obvious difference was not observed in global longitudinal strain (GLS) between the controlled blood glucose group and the control group (- 20.34% vs - 21.22%, P = 0.068). Compared with the healthy controls, the uncontrolled blood glucose group showed an impaired GLS (- 18.62% vs - 21.22%, P < 0.001). Nevertheless, PSD was appreciably increased in the controlled blood glucose group (36.02 ms vs 32.48 ms, P = 0.01) and uncontrolled blood glucose group (57.51 ms vs 32.48 ms, P < 0.001). Multivariate linear regression analysis showed that HbA1c was closely related to PSD lesion in the LV in the T2DM group (β = 0.520, P < 0.001). PSD plays an important role in evaluating the coordination and synchronization of myocardial movement and provides a more accurate and sensitive index assessment of early LV systolic function in T2DM patients. In addition, HbA1c levels were related to LV dysfunction.
心血管疾病是糖尿病（DM）患者死亡的主要原因之一。本研究旨在探讨峰值应变离散度（PSD）在发现 2 型糖尿病（T2DM）患者早期左心室（LV）功能障碍中的价值。本研究选择了 101 例 T2DM 患者和 60 例健康受试者。T2DM 患者进一步分为血糖控制良好（HbA1c<7%，n=46）和血糖控制不佳（HbA1c≥7%，n=55）亚组。所有参与者均接受常规超声心动图和二维斑点追踪超声心动图检查。我们的研究结果表明，血糖控制良好组和对照组之间的整体纵向应变（GLS）无明显差异（-20.34%比-21.22%，P=0.068）。与健康对照组相比，血糖控制不佳组的 GLS 明显受损（-18.62%比-21.22%，P<0.001）。然而，血糖控制良好组（36.02ms比32.48ms，P=0.01）和血糖控制不佳组（57.51ms比32.48ms，P<0.001）的 PSD 显著增加。多元线性回归分析表明，HbA1c 与 T2DM 组 LV 中 PSD 病变密切相关（β=0.520，P<0.001）。PSD 在评估心肌运动的协调性和同步性方面具有重要作用，为 T2DM 患者早期 LV 收缩功能提供了更准确、更敏感的指标评估。此外，HbA1c 水平与 LV 功能障碍有关。
