The Correlation Analysis Between Left Ventricular Mass Index And Lesion Severity Of Coronary Artery Disease In Diabetic Patients Abstract

Objective:To investigate the correlation between left ventricular mass index(LVMI)and severity of coronary artery disease in patients with type 2 diabetes mellitus(DM),and to provide a clue and method for predicting and evaluating the severity of coronary artery disease in diabetic patients.Methods:A total of 536 patients with type 2 diabetes mellitus who were admitted to the department of cardiology of our hospital and underwent coronary angiography from June 2017 to June 2020 were selected.According to the coronary angiography findings,the Gensini score was calculated,then the patients were divided into normal control group(Gensini score=0,44 cases),and coronary artery lesion group(Gensini score≥0,492 cases),the coronary artery lesion group were divided into mild lesion group(0<Gensini score≤20,245 cases),moderate lesion group(20<Gensini score≤40,118cases),severe lesion group(Gensini score>40,129 cases).The general data and related biochemical data of all patients were collected,and the results of echocardiography were collected to obtain the parameters of left ventricular end systolic diameter(LVES),left ventricular end diastolic diameter(LVED),interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPW),left ventricular ejection fraction(LVEF)and so on.Left ventricular mass index(LVMI)was calculated.The general data,biochemical data and echocardiographic parameters between normal control group and coronary artery lesion group were compared;The echocardiographic parameters of coronary artery lesion were compared among each subgroup;The correlation between LVMI and coronary artery lesion was explored by univariate and multivariate logistic regression analysis;To make the ROC curve for predicting the degree of coronary artery disease by LVMI was analyzed;Pearson analysis was used to explore the correlation between related factors and the severity of coronary artery lesion.Results:1.Between the normal control group and coronary artery disease group,there were significant differences in male proportion,smoking,systolic blood pressure,high density lipoprotein cholesterol,creatinine,IVST(9.81±1.14 vs 10.51±1.49),LVPW(9.37±1.08 vs 9.87±1.30),LVED(44.89±3.56 vs 47.11±4.46),LVMI(93.47±19.13 vs110.06±26.99)(P<0.05).2.Multivariate logistic regression analysis showed that systolic blood pressure,HDL-C,LVPW and LVMI were significantly correlated with coronary artery disease in diabetic patients(P<0.05).3.The cut-off value of LVMI for predicting the occurrence of coronary artery disease in DM patients was 110.11g/m~2,The AUC was 0.693,the sensitivity was 45.0%,and the specificity was 90.9%.4.The echocardiographic parameters were compared among normal control group,mild lesion group,moderate lesion group,and severe lesion group,LVMI of mild lesion group was higher than that of normal control group(P<0.05);IVST,LVPW,LVED,and LVMI of moderate lesion group were higher than those of normal control group and mild lesion group(P<0.05);IVST,LVPW,LVED,LVES and LVMI of severe lesion group were higher than those of normal control group and mild lesion group(P<0.05);LVES in severe lesion group was higher than that in moderate lesion group(P<0.05),LVEF was lower than that in moderate lesion group(P<0.05).5.Pearson correlation analysis showed that Gensini score was positively correlated with LVMI(P<0.05),positively correlated with glycosylated hemoglobin,serum creatinine,IVST,LVPW,LVED,and LVES(P<0.05),and negatively correlated with high density lipoprotein cholesterol and LVEF.The above indexes with statistical significance were substituted into multiple linear regression equation,which showed that high density lipoprotein cholesterol,glycosylated hemoglobin,serum creatinine,LVEF,LVES,LVPW,LVMI were significantly correlated with Gensini score(P<0.05).Conclusions:1.In diabetic patients with coronary artery lesion,the proportion of men is high,smoking more,systolic blood pressure and creatinine level is high,while the level of high density lipoprotein cholesterol is low,IVST,LVPW,LVED and LVMI are high.2.Systolic blood pressure is an independent risk factor for coronary artery disease in diabetic patients,and HDL-C is an independent protective factor for coronary artery disease in diabetic patients.3.LVPW and LVMI can be used as independent predictors of coronary artery disease in diabetic patients.LVMI has a certain sensitivity and high specificity in predicting coronary artery disease in diabetic patients.4.Glycosylated hemoglobin,serum creatinine,LVES,LVPW and LVMI are independent risk factors for the severity of coronary artery disease in diabetic patients.5.LVMI was positively correlated with the severity of coronary artery stenosis,and LVMI is increased with the severity of coronary artery stenosis.