Evaluation Of Right Ventricular Function And Synchronization With Real-time Three Dimensional Echocardiography And Velocity Vector Imaging In Patients With Diabetes Mellitus

Objective :To evaluate right ventricular function and synchronization in patients with type 2 diabetes mellitus(T2DM)by real-time three-dimensional echocardiography(RT-3DE)and velocity vector imaging(VVI).Methods :A total of 60 T2 DM patients hospitalized in the Department of Endocrinology,the First Hospital of Lanzhou University from August 2021 to May2022 were selected as T2 DM group.The risk of cardiovascular related poor prognosis of diabetes mellitus is closely related to the level of hemoglobin Alc(Hb A1c).Therefore,T2 DM patients were divided into non-high risk group(NHR group,Hb A1c<9)and high risk group(HR group,Hb A1c≥9),with 30 patients in each group.healthy people were selected as normal control group in the same period.The right ventricular function measured by conventional two-dimensional echocardiography,VVI and RT-3DE was compared between the groups.The correlation between Hb A1 c and Right ventricular function in T2 DM patients was analyzed.Rescults: 1.Right ventricular strain and synchronization parameters:The right ventricular strain and synchronization parameters were compared between the control group,the whole T2 DM group and the subgroup,respectively.The results showed that compared with the control group,the GLSRl,FWLSRl in the HR group was increased,but there was no significant difference(P>0.05).Compared with the control group,the right ventricular systolic function parameters GLS,GLSR,FWLS and FWLSR were significantly decreased(P<0.05),diastolic function parameters GLSRe and FWLSRe were significantly decreased in the HR group and the T2 DM group(P<0.05).right ventricular GLS in HR group was further decreased than that in NHR group(P<0.01).2.Right ventricular three-dimensional volume parameters: The right ventricular three-dimensional volume parameters were compared between the control group,the whole T2 DM group and the subgroup,respectively.the results showed that there was no statistical significance in RVESV RVESVI between the control group and T2 DM group and subgroup(P>0.05).RVEDV RVSV RVEDVI RVSVI in T2 DM and NHR groups was significantly lower than that normal control group(P<0.05),RVEF in T2 DM and HR groups was significantly lower than that in control group(P<0.01).3.Pearson correlation between Hb A1 c and right ventricular function parameters:Pearson correlation analysis showed that Hb A1 c was negatively correlated with right ventricular GLS(r=-0.402,P<0.01)and negatively correlated with RVSVI(r=-0.262,P<0.05)in T2 DM patients.Conclusions : Velocity vector imaging can comprehensively analyze right ventricular systolic and diastolic dysfunction and right ventricular synchronization in patients with T2 DM from the perspective of myocardial movement.Real-time threedimensional echocardiography can accurately present the morphology of the right ventricle through three-dimensional imaging,and comprehensively detect the subclinical changes in the volume and function of the right ventricle in patients with T2 DM than conventional two-dimensional echocardiography.patients with type 2diabetes have impaired right ventricular myocardial function,and the increased risk of cardiovascular-related adverse outcomes in patients with T2 DM is associated with further impairment of right ventricular function due to poor glycemic control.