Li Guang-An, Huang Jun, Sheng Xiao, Fan Li
Department of Echocardiography, The Affiliated Changzhou Second People's Hospital with Nanjing Medical University, Changzhou, 213003, China.
Department of Endocrinology, The Affiliated Changzhou Second People's Hospital with Nanjing Medical University, Changzhou, 213003, China.
Diabetol Metab Syndr. 2023 Oct 13;15(1):200. doi: 10.1186/s13098-023-01180-0.
The research was aimed to evaluate the subclinical left ventricular (LV) myocardial systolic dysfunction in T2DM patients with or without hypertension (HT) by global and segmental myocardial work (MW).
A total of 120 T2DM patients (including 60 T2DM patients with HT) and 70 sex- and age- matched normal controls were included. The global and segmental variables of work index (WI), constrictive work (CW), waste work (WW), work efficiency (WE), and CW/WW were analysed by non-invasive pressure-strain loop. Receiver operating characteristic (ROC) analysis was performed for detection the subclinical LV systolic dysfunction in T2DM patients with and without HT.
The global work index (GWI), global CW (GCW), global WE (GWE), and GCW/global WW (GWW) of T2DM and T2DM patients with HT were significantly lower than normal controls (p < 0.05). The WI, CW, WE, and CW/WW of the LV anterior wall in T2DM and T2DM patients with HT were significantly lower when compared with those of the normal controls (p < 0.05). ROC analysis showed that the value of area under the curve (AUC) in combined GWI, GCW, GWE, and GCW/GWW was significantly higher than the AUCs of the individual indices (p < 0.05).
MW can non-invasively and accurately evaluate subclinical global and segmental LV myocardial systolic dysfunction in T2DM patients with and without HT. Regulating total cholesterol levels and controlling blood pressure in T2DM patients with and without HT might reduce the impairment of LV myocardial systolic function.
本研究旨在通过整体和节段性心肌做功（MW）评估有或无高血压（HT）的2型糖尿病（T2DM）患者的亚临床左心室（LV）心肌收缩功能障碍。
共纳入120例T2DM患者（包括60例合并HT的T2DM患者）和70例性别及年龄匹配的正常对照者。通过无创压力应变环分析整体和节段性做功指数（WI）、收缩功（CW）、无用功（WW）、做功效率（WE）及CW/WW等变量。对有和无HT的T2DM患者进行亚临床LV收缩功能障碍检测的受试者工作特征（ROC）分析。
T2DM患者及合并HT的T2DM患者的整体做功指数（GWI）、整体CW（GCW）、整体WE（GWE）及GCW/整体WW（GWW）均显著低于正常对照者（p<0.05）。与正常对照者相比，T2DM患者及合并HT的T2DM患者左室前壁的WI、CW、WE及CW/WW均显著降低（p<0.05）。ROC分析显示，联合GWI、GCW、GWE及GCW/GWW的曲线下面积（AUC）值显著高于各单项指标的AUC值（p<0.05）。
MW可无创且准确地评估有或无HT的T2DM患者的亚临床整体和节段性LV心肌收缩功能障碍。调控有或无HT的T2DM患者的总胆固醇水平并控制血压可能会减轻LV心肌收缩功能的损害。
