Department of Ultrasound, Affiliated Hospital of Southwest Medical University, Luzhou, China.
Department of Public Health, Evangelismos Private Hospital, Luzhou, China.
J Med Ultrason (2001). 2024 Jul;51(3):447-455. doi: 10.1007/s10396-024-01456-6. Epub 2024 May 8.
We sought to detect left ventricular (LV) adverse alterations in structure and function in type 2 diabetes mellitus (T2DM) patients with or without mild renal dysfunction (MRD) using comprehensive echocardiography techniques and to explore the independent risk factors for LV remodeling (LVR) and dysfunction in these patients.
The study included 82 T2DM patients with normal LV ejection fraction (presence (n = 42)/absence (n = 40) of MRD). Age- and gender-matched controls (n = 40) were also recruited. LV structure and function were evaluated using conventional echocardiography and three-dimensional speckle tracking echocardiography (3DSTE). Global longitudinal strain (GLS), global circumferential strain (GCS), global area strain (GAS), and global radial strain (GRS) were all measured using 3DSTE.
Compared with the controls with absolute advantage of LV normal geometry, LVR was more frequently present in the two T2DM groups, with the largest proportion in those with T2DM and MRD (P < 0.001). Fasting plasma glucose (FPG) and MRD were both significant risk factors for LVR in T2DM patients. The detection rates of LV diastolic dysfunction and subclinical systolic dysfunction were significantly higher in the T2DM groups than in the controls (P = 0.000). Moreover, the two case groups also showed significantly lower strain values in multiple directions than the controls (all P < 0.05). FPG was significantly associated with LV diastolic dysfunction, whereas FPG and MRD were both significantly associated with subclinical LV systolic dysfunction in T2DM patients.
The combined use of conventional echocardiography and 3DSTE allowed the timely detection of early cardiac damage in T2DM patients with or without MRD.
我们旨在使用综合超声心动图技术检测 2 型糖尿病（T2DM）伴或不伴轻度肾功能不全（MRD）患者的左心室（LV）结构和功能的不良改变，并探讨这些患者发生 LV 重构（LVR）和功能障碍的独立危险因素。
本研究纳入了 82 例左心室射血分数正常的 T2DM 患者（MRD 存在（n=42）/不存在（n=40））。还招募了年龄和性别匹配的对照组（n=40）。使用常规超声心动图和三维斑点追踪超声心动图（3DSTE）评估 LV 结构和功能。使用 3DSTE 测量整体纵向应变（GLS）、整体周向应变（GCS）、整体面积应变（GAS）和整体径向应变（GRS）。
与具有 LV 正常几何结构的对照组相比，LVR 在 T2DM 两组中更为常见，以 T2DM 伴 MRD 患者的比例最大（P<0.001）。空腹血糖（FPG）和 MRD 均是 T2DM 患者发生 LVR 的重要危险因素。T2DM 组的 LV 舒张功能障碍和亚临床收缩功能障碍的检出率明显高于对照组（均 P<0.001）。此外，两组病例组的多个方向的应变值也明显低于对照组（均 P<0.05）。FPG 与 LV 舒张功能障碍显著相关，而 FPG 和 MRD 均与 T2DM 患者的亚临床 LV 收缩功能障碍显著相关。
常规超声心动图与 3DSTE 的联合应用可及时检测 T2DM 伴或不伴 MRD 患者的早期心脏损伤。
