Song Xiang-Ting, Fan Li, Yan Zi-Ning, Rui Yi-Fei
Department of Echocardiography, Changzhou No.2 People's Hospital Affiliated to Nanjing Medical University, Changzhou 213003, China.
Department of Echocardiography, Changzhou No.2 People's Hospital Affiliated to Nanjing Medical University, Changzhou 213003, China.
J Diabetes Complications. 2021 Jul;35(7):107943. doi: 10.1016/j.jdiacomp.2021.107943. Epub 2021 Apr 26.
Type 2 diabetes mellitus (T2DM) is associated with high cardiovascular risk. Preclinical left ventricular (LV) dysfunction and subclinical arterial stiffness have been documented in patients with T2DM. The aims of this study were to investigate whether there were any differences in LV function and ascending aorta elasticity between T2DM patients with controlled [defined as glycosylated hemoglobin (HbA1c) <6.5%] and uncontrolled (HbA1c ≥6.5%) blood glucose.
We studied 86 T2DM patients: 42 T2DM patients with controlled blood glucose (controlled T2DM group) and 44 T2DM patients with uncontrolled blood glucose (uncontrolled T2DM group), and 40 healthy subjects as control. They all underwent transthoracic echocardiography examination, LV systolic function was evaluated by global longitudinal strain (GLS) and LV diastolic function was defined as the ratio of the early diastolic transmitral flow velocity (E) to average mitral annular velocity (e¯). Ascending aorta inner diameters and brachial blood pressure were measured to calculate ascending aorta elastic parameters: compliance (C), distensibility (D), strain (S), stiffness index (SI), Peterson's elastic modulus (EM).
Compared to control, T2DM patients had reduced GLS, increased E/e ̅ and impaired ascending aorta elasticity. Furthermore, LV function and ascending aorta elasticity were more severely damaged in uncontrolled T2DM group compared with controlled T2DM group. By Pearson correlation analysis, the level of HbA was independently associated with the parameters of the LV function and ascending aorta elasticity.
T2DM can impair the LV myocardial function and ascending aorta elastic properties, which may be further impaired by poor blood glucose control.
2型糖尿病（T2DM）与心血管疾病高风险相关。T2DM患者已被证实存在临床前左心室（LV）功能障碍和亚临床动脉僵硬度增加。本研究的目的是调查血糖控制良好（糖化血红蛋白（HbA1c）<6.5%）和控制不佳（HbA1c≥6.5%）的T2DM患者在左心室功能和升主动脉弹性方面是否存在差异。
我们研究了86例T2DM患者，其中42例血糖控制良好的T2DM患者（血糖控制良好的T2DM组）和44例血糖控制不佳的T2DM患者（血糖控制不佳的T2DM组），并以40名健康受试者作为对照。他们均接受经胸超声心动图检查，左心室收缩功能通过整体纵向应变（GLS）评估，左心室舒张功能定义为舒张早期二尖瓣血流速度（E）与平均二尖瓣环速度（e¯）的比值。测量升主动脉内径和肱动脉血压以计算升主动脉弹性参数：顺应性（C）、扩张性（D）、应变（S）、僵硬度指数（SI）、彼得森弹性模量（EM）。
与对照组相比，T2DM患者的GLS降低，E/e ̅升高，升主动脉弹性受损。此外，与血糖控制良好的T2DM组相比，血糖控制不佳的T2DM组左心室功能和升主动脉弹性受损更严重。通过Pearson相关性分析，HbA水平与左心室功能和升主动脉弹性参数独立相关。
T2DM可损害左心室心肌功能和升主动脉弹性特性，血糖控制不佳可能会使其进一步受损。
