Echocardiographic Detection of Subclinical Left Ventricular Dysfunction in Asymptomatic Type Two Diabetes Mellitus
Laila Nazmy Shabaan
Department of Cardiovascular Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt.
Mahmoud Abd El Khalek Abou Omar
Department of Cardiovascular Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt.
Mohammed Naseem Hussien
Department of Cardiovascular Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt.
Ekram Sadek Saeed
Department of Cardiovascular Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt.
*Author to whom correspondence should be addressed.
Abstract
Background: Before systolic dysfunction and symptomatic heart, diabetic cardiomyopathy begins with left ventricular diastolic dysfunction (LVDD). Echocardiographic modalities were used to detect subclinical LV impairment in asymptomatic type 2 diabetics. This study aimed to identify subclinical left ventricular impairment in asymptomatic patients with type two diabetes using several echocardiographic techniques.
Methods: In the present prospective cohort study, 30 adults over 18 having type II diabetes mellitus (DM) (Group I) and 20 normal controls (Group II) were studied. Transthoracic echocardiography and 12-lead ECG were performed on all individuals.
Results: Pulsed wave Doppler techniques revealed significant variation in transmitral flow velocities between groups, including septal e', lateral mitral annulus early velocity (e'), septal early diastolic peak flow velocity (E)\e', Lateral E\e', and average E\e'. EF was significantly decreased in group I (P < 0.001). With a p-value of 0.001, LVESD was significantly higher in group I. The septal, lateral, and average systolic mitral annulus (S') motions in group II were significantly larger than those in group I. When comparing groups, I and II, the first showed much longer myocardial performance index (MPI) and isovolumetric contraction time (IVCT). The ET for Group I was significantly lower than that of Group II. The study group exhibited significantly greater levels of fasting blood sugar, post-prandial blood sugar, and haemoglobin A1C (HBA1C) compared to the control group (P <0.001).
Conclusions: Patients having diabetes mellitus exhibited considerably greater levels of DM history fasting glucose levels, postprandial glucose levels, haemoglobin A1C (HBA1C), E/e´ ratio, LVESD, IVCT, and MPI, while having significantly lower EF and ET relative to the healthy group.
Keywords: Left ventricular dysfunction, asymptomatic, diabetes mellitus, echocardiography