Cheng Qiao, Huang Xiao, Fan Xinying, Sun Jie, Zhang Jun, Tang Qiaoying, Deng Youbin, Bi Xiaojun
Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Cardiovasc Med. 2023 Jun 12;10:1162500. doi: 10.3389/fcvm.2023.1162500. eCollection 2023.
Diabetes predisposes affected individuals to impaired myocardial perfusion and ischemia, leading to cardiac dysfunction. Increased myocardial stiffness is an independent and significant risk factor in diastolic dysfunction. This study sought to estimate myocardial stiffness in Type 2 diabetes (T2DM) patients using the intrinsic wave velocity propagation (IVP) along the longitudinal wall motion during late diastole and evaluate the value of IVP in assessing cardiac function and structure.
87 and 53 participants with and without T2DM (control group) were enrolled. Of the 87 T2DM patients (DM group), 43 were complicated with hypertension (DM + H group), and 44 were not (DM-H group). Ultrasound parameters were measured and analyzed, including color M-mode flow propagation velocity, global longitudinal systolic strain (GLS), and IVP.
IVP was higher in the DM group than in the control group (1.62 ± 0.25 m/s and 1.40 ± 0.19 m/s, < 0.001). After stratification for hypertension, IVP in both DM + H (1.71 ± 0.25 m/s) and DM-H (1.53 ± 0.20 m/s) groups were found to be significantly higher than that in the control group (1.40 ± 0.19 m/s); also, the difference of IVP between DM + H and DM-H group reached statistical significance. Moreover, IVP was significantly correlated with flow propagation velocity during early diastole (Pve) ( = -0.580, < 0.001), flow propagation velocity during late diastole (Pva) ( = 0.271, < 0.001), GLS ( = 0.330, < 0.001), interventricular septal thickness at end-diastole (IVSd) ( = 0.321, < 0.001), blood glucose ( = 0.246, < 0.003), systolic blood pressure ( = 0.370, < 0.001) and diastolic blood pressure ( = 0.389, < 0.001).
The results indicated the application potential of IVP in assessing the early detection of cardiac function changes noninvasively and sensitively. The correlation with myocardial stiffness warrants further studies to substantiate its potential clinical utility.
糖尿病使患者易发生心肌灌注受损和缺血，进而导致心脏功能障碍。心肌僵硬度增加是舒张功能障碍的一个独立且重要的危险因素。本研究旨在利用舒张末期沿纵向壁运动的固有波速传播（IVP）来评估2型糖尿病（T2DM）患者的心肌僵硬度，并评估IVP在评估心脏功能和结构方面的价值。
招募了87名患有T2DM的参与者和53名未患T2DM的参与者（对照组）。在87名T2DM患者（糖尿病组）中，43名合并高血压（糖尿病+高血压组），44名未合并高血压（糖尿病-高血压组）。测量并分析了超声参数，包括彩色M型血流传播速度、整体纵向收缩期应变（GLS）和IVP。
糖尿病组的IVP高于对照组（分别为1.62±0.25m/s和1.40±0.19m/s，P<0.001）。在按高血压分层后，发现糖尿病+高血压组（1.71±0.25m/s）和糖尿病-高血压组（1.53±0.20m/s）的IVP均显著高于对照组（1.40±0.19m/s）；此外，糖尿病+高血压组和糖尿病-高血压组之间的IVP差异具有统计学意义。此外，IVP与舒张早期血流传播速度（Pve）（r=-0.580，P<0.001）、舒张晚期血流传播速度（Pva）（r=0.271，P<0.001）、GLS（r=0.330，P<0.001）、舒张末期室间隔厚度（IVSd）（r=0.321，P<0.001）、血糖（r=0.246，P<0.003）、收缩压（r=0.370，P<0.001）和舒张压（r=0.389，P<0.001）均显著相关。
结果表明IVP在无创、敏感地评估心脏功能变化的早期检测方面具有应用潜力。其与心肌僵硬度的相关性值得进一步研究以证实其潜在的临床应用价值。
