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二维斑点追踪超声心动图在检测糖尿病患者亚临床左心室收缩功能障碍中的应用价值

Usefulness of Two-Dimensional Speckle-Tracking Echocardiography in Detecting Subclinical Left Ventricular Systolic Dysfunction in Diabetes Mellitus.

作者信息

Ahmed Khair Loay, Ali Samah, Alansari Murouj

机构信息

Internal Medicine/Cardiology, Security Forces Hospital, Makkah, SAU.

出版信息

Cureus. 2025 Jun 10;17(6):e85682. doi: 10.7759/cureus.85682. eCollection 2025 Jun.

Abstract

This study aimed to evaluate left ventricular (LV) systolic function in asymptomatic patients with diabetes compared to a normal population using global longitudinal strain (GLS) measured by two-dimensional speckle-tracking echocardiography (2DSTE). Impaired LV systolic function was defined as GLS <-18%. Data were analyzed from two groups: a normal cohort (n=57) and a diabetic cohort (n=50). In the normal group, the mean GLS was -20.1%, with 16% of individuals exhibiting impaired LV systolic function. In contrast, the diabetic group demonstrated a significantly lower mean GLS of -17.3%, with 37% showing impaired function, suggesting subclinical myocardial dysfunction in asymptomatic patients with diabetes. Correlation analysis within the diabetic group revealed a moderate negative correlation between GLS and duration of diabetes (r=-0.42, p<0.05), glycated hemoglobin levels (r=-0.35, p<0.05), and low-density lipoprotein cholesterol levels (r=-0.28, p<0.05), indicating that prolonged disease duration and poorer glycemic control are associated with reduced LV systolic function. Further analysis of the normal group revealed no significant gender differences in GLS (p=0.12 ), but age stratification showed a trend toward declining GLS with advancing age (p=0.04 ). These findings underscore the utility of GLS as an early marker of LV dysfunction in asymptomatic patients with diabetes and highlight the influence of age on cardiac function in healthy individuals. Future studies should focus on larger cohorts to validate these results and explore therapeutic interventions to mitigate subclinical cardiac dysfunction in diabetic populations.

摘要

本研究旨在通过二维斑点追踪超声心动图(2DSTE)测量的整体纵向应变(GLS),评估无症状糖尿病患者与正常人群相比的左心室(LV)收缩功能。左心室收缩功能受损定义为GLS<-18%。对两组数据进行了分析:正常队列(n=57)和糖尿病队列(n=50)。在正常组中,平均GLS为-20.1%,16%的个体表现出左心室收缩功能受损。相比之下,糖尿病组的平均GLS显著降低,为-17.3%,37%的患者表现出功能受损,提示无症状糖尿病患者存在亚临床心肌功能障碍。糖尿病组内的相关性分析显示,GLS与糖尿病病程(r=-0.42,p<0.05)、糖化血红蛋白水平(r=-0.35,p<0.05)和低密度脂蛋白胆固醇水平(r=-0.28,p<0.05)之间存在中度负相关,表明病程延长和血糖控制较差与左心室收缩功能降低有关。对正常组的进一步分析显示,GLS在性别上无显著差异(p=0.12),但按年龄分层显示,随着年龄增长,GLS有下降趋势(p=0.04)。这些发现强调了GLS作为无症状糖尿病患者左心室功能障碍早期标志物的实用性,并突出了年龄对健康个体心脏功能的影响。未来的研究应集中在更大的队列上,以验证这些结果,并探索治疗干预措施,以减轻糖尿病患者的亚临床心脏功能障碍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa4d/12244792/e64b41aaa47e/cureus-0017-00000085682-i01.jpg

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