Sharma Vinay Kumar, Tikadar Rakesh Kumar, Tripathi Sunil K, Tondon Mohit, Aggarwal Puneet
Cardiology, Fortis Escorts Heart Institute and Research Centre, Delhi, IND.
Cardiology, Shyam Shah Medical College, Rewa, IND.
Cureus. 2025 Feb 21;17(2):e79429. doi: 10.7759/cureus.79429. eCollection 2025 Feb.
The relationship between glycemic control and cardiovascular outcomes is significant. Subclinical systolic impairment could be the first indicator of diabetic cardiomyopathy, even before detectable changes in ejection fraction.
To determine the prevalence of left ventricular (LV) systolic dysfunction by global longitudinal strain (GLS) in patients with asymptomatic type 2 diabetes mellitus (T2DM) patients with preserved ejection fraction and correlate GLS with stress echocardiography positivity rates in these patients. Methods This prospective, observational, cross-sectional, single-center study included 150 asymptomatic T2DM patients with preserved left ventricular ejection fraction (LVEF≥50%). Patients underwent comprehensive echocardiography, which included GLS measurement and stress echocardiography. Patients were categorized based on GLS values (normal:≥-17%; reduced:<-17%) and stress echocardiography results.
The LV systolic dysfunction, defined by reduced GLS, was observed in 37.7% of patients. Patients with reduced GLS were older (64.42±11.01 vs. 55.09±12.20 years, p<0.001), had higher HbA1c levels (8.6±0.99% vs. 7.05±1.05%, p<0.001), and longer diabetes duration (10.43±5.59 vs. 6.32±5.90 years, p<0.001). Stress echocardiography positivity was significantly higher in the reduced GLS group compared to the normal GLS group (17.9% vs 4.3%, p=0.006). Patients with positive stress echocardiography results showed significantly lower average GLS compared to those with negative results (16.16±3.96% vs 18.69±3.45%, p=0.04).
In asymptomatic T2DM patients with preserved LVEF, reduced GLS is associated with a higher rate of positive stress echocardiography results. The LV systolic dysfunction, indicated by reduced GLS, is common in diabetic patients and associated with higher HbA1c and longer diabetes duration.
血糖控制与心血管结局之间的关系十分显著。亚临床收缩功能损害可能是糖尿病性心肌病的首个指标，甚至早于射血分数出现可检测到的变化之前。
通过整体纵向应变（GLS）确定射血分数保留的无症状2型糖尿病（T2DM）患者左心室（LV）收缩功能障碍的患病率，并将GLS与这些患者的负荷超声心动图阳性率相关联。方法 这项前瞻性、观察性、横断面、单中心研究纳入了150例射血分数保留（左心室射血分数[LVEF]≥50%）的无症状T2DM患者。患者接受了全面的超声心动图检查，包括GLS测量和负荷超声心动图检查。根据GLS值（正常：≥-17%；降低：<-17%）和负荷超声心动图结果对患者进行分类。
37.7%的患者观察到由GLS降低定义的LV收缩功能障碍。GLS降低的患者年龄更大（64.42±11.01岁 vs. 55.09±12.20岁，p<0.001），糖化血红蛋白（HbA1c）水平更高（8.6±0.99% vs. 7.05±1.05%，p<0.001），糖尿病病程更长（10.43±5.59年 vs. 6.32±5.90年，p<0.001）。与正常GLS组相比，GLS降低组的负荷超声心动图阳性率显著更高（17.9% vs 4.3%，p=0.006）。负荷超声心动图结果为阳性的患者的平均GLS显著低于结果为阴性的患者（16.16±3.96% vs 18.69±3.45%，p=0.04）。
在LVEF保留的无症状T2DM患者中，GLS降低与负荷超声心动图阳性率较高相关。由GLS降低表明的LV收缩功能障碍在糖尿病患者中很常见，并且与更高的HbA1c和更长的糖尿病病程相关。
