Department of Medical Ultrasonics, First Affiliated Hospital With Jinzhou Medical University, No. 2, Section 5, Renmin Street, Guta District, Jinzhou, 121001, Liaoning Province, China.
Sci Rep. 2023 Jan 20;13(1):1101. doi: 10.1038/s41598-023-28262-3.
The global incidence of diabetes and related complications is gradually increasing, with cardiovascular complications being the leading cause of death in the diabetic population. The purpose of this study was to examine left ventricular function in individuals with type 2 diabetes mellitus (T2D) and conduct a feasibility analysis using automated cardiac motion quantification (aCMQ) approach. A total of 150 T2D patients with a history of diabetes mellitus dating back more than 10 years were chosen, and we treated 87 patients with T2D that had been present for less than 15 years as group I, 63 patients with T2D that had been present for more than 15 years as group II, and 50 healthy volunteers as the control group. From the three groups, clinical information, conventional ultrasonography parameters, and mitral annular plane systolic excursion (MAPSE) parameters were gathered. aCMQ technique was used to collect longitudinal strain and circumferential strain in the left ventricle. Tissue motion mitral annular displacement technique (TMAD) in aCMQ was used to collect parameters related to TMAD, and cardiac motion quantification (CMQ) was used to collect two-dimensional global longitudinal strain (2D-GLS) to compare the degree of difference between the aforementioned three groups. The differences between longitudinal strain groups in aCMQ were all statistically significant and gradually decreased with increasing disease duration. Most TMAD parameters were lower in groups I and II than in the control group, and TMAD parameters gradually decreased with increasing disease duration. The results of the LV global longitudinal strain and 2D-GLS using Bland-Altman analyses showed high agreement between and within groups, Pearson correlation analysis showed a significant positive correlation (r = 0.18, P < 0.05), and the AUC of ROC curves predicting the value of left ventricular function in patients with T2D was 0.723 and 0.628, respectively. With significant positive correlations between MAPSE, s', and the majority of the TAMD parameters (P < 0.05), TAMD, MAPSE, and s' demonstrated high inter- and intra-group agreement using Bland-Altman analyses, and the three had predictive value in assessing left ventricular function in T2D patients by ROC curve. Reduced longitudinal strain and reduced mitral annular displacement were seen in patients with different disease stages of T2D, so the application of aCMQ and TAMD was effective in detecting altered left ventricular function in patients with T2D. aCMQ had higher value in predicting left ventricular function in patients with T2D compared to CMQ for overall longitudinal strain, and the software performed the depiction automatically, reducing manual errors. MAPSE parameters and s ' can replace the TMAD technique for assessing mitral annular motion and was simpler to perform, saving operational time.
全球糖尿病及其相关并发症的发病率逐渐升高，心血管并发症是糖尿病患者死亡的主要原因。本研究旨在探讨 2 型糖尿病（T2DM）患者的左心室功能，并采用自动化心脏运动定量（aCMQ）方法进行可行性分析。选择了 150 名病史超过 10 年的 T2DM 患者，将病程＜15 年的 87 例 T2DM 患者作为 I 组，病程＞15 年的 63 例 T2DM 患者作为 II 组，50 例健康志愿者作为对照组。从三组中收集临床资料、常规超声心动图参数和二尖瓣环平面收缩期位移（MAPSE）参数。应用 aCMQ 技术采集左心室的纵向应变和周向应变。aCMQ 中的组织运动二尖瓣环位移技术（TMAD）用于采集与 TMAD 相关的参数，心脏运动定量（CMQ）用于采集二维整体纵向应变（2D-GLS），比较三组间差异程度。aCMQ 中纵向应变组的差异均有统计学意义，且随病程的延长逐渐降低。I 组和 II 组的大多数 TMAD 参数均低于对照组，且 TMAD 参数随病程的延长逐渐降低。通过 Bland-Altman 分析对 LV 整体纵向应变和 2D-GLS 进行组间和组内比较，结果显示组间和组内高度一致，Pearson 相关分析显示有显著正相关（r=0.18，P＜0.05），ROC 曲线预测 T2DM 患者左心室功能的 AUC 值分别为 0.723 和 0.628。MAPSE、s'与大多数 TAMD 参数之间存在显著正相关（P＜0.05），Bland-Altman 分析显示 TAMD、MAPSE 和 s'的组间和组内高度一致，ROC 曲线显示三者对 T2DM 患者左心室功能有预测价值。不同病程 T2DM 患者的纵向应变和二尖瓣环位移均降低，因此 aCMQ 和 TAMD 可有效检测 T2DM 患者左心室功能的改变。与整体纵向应变的 CMQ 相比，aCMQ 对 T2DM 患者左心室功能的预测值更高，且软件自动进行描绘，减少了手动误差。MAPSE 参数和 s'可替代 TMAD 技术评估二尖瓣环运动，操作更简单，节省操作时间。
