| Object To study the effection of diabetes mellitu(sDM) on left and right ventricular function by Color-tissue Doppler imaging (C-TDI),and to explore the usefulness of C-TDI for evaluation of heart function in DM patients with or without systemic hypertension(SH).Methods Study population were divided into 4 groups:(1) 36 patients with DM, (2) 30 patients with SH,(3) 27patients with SH+DM(diabetes mellitus and systemic hypertension), and (4) 33 healthy subjects(controls). Interventricular septum thickness (IVSd),Left ventricular posterior wall thickness (LVPWd),Left ventricular internal dimensions (LVIDd) in end diastole were measured by M-mode Echocardiography and two dimensional echocardiography . Left ventricular eject faction (EF) was assessed by improved Simpson formula.Conventional left ventricular diastolic function parameters were acquired by pulsed Doppler. LV mass was calculated by the Devereux-modified American Society of Echocardiography cube formula and indexed for body surface area to obtain the LV mass index. The mitral and the tricuspid flow velocity, deceleration time of early diastolic mitral flow and early diastolic tricuspid flow, isovolumic relaxation time were measured by the pulse Doppler,and the E/A was calculated .The mitral annular and the tricuspid annular peak systolic (Sm) and early diastolic (Em) and peak late (Am) velocities were determined by Color TDI in the apical views (4- and 2-chamber, and long-axis),and the Em/Am , the E/Em and Tei index were calculated.Then the function parameters of the DM group,SH group and DM+SH group were compared with the control, and the correlation between the parameters were analyzed.Result⑴The mean early diastolic (Em) velocities and Em/Am of the mitral annalas in the patients with DM,SH or DM+SH were significantly lower than in the control,and there were obviously differerance among them(mean Em:6.46±2.14,5.72±1.67,4.95±1.70,7.08±1.08, respectively,p<0.001;mean Em/Am:0.91±0.30,0.90±0.30,0.69±0.27,1.20±0.34, respectively,p<0.001).⑵The mean systolic (Sm) velocities of the mitral annalas had no statistics difference(p>0.05) among them.The meam E/Em in the patients with DM,SH and DM+SH were significantly higher than the control,and there were obviously differerance among them(14.5±3.6,14.9±3.4,18.1±7.7,11.8±1.9, respectively, p<0.001). The systolic (Sm) velocities of the tricuspid annalas in right ventricular had no statistics difference(p>0.05) among the groups, however the Em and Em/Am were significantly lower than the control, and there were obviously differerance among them (p<0.05 and p=0.01 respectively).⑶The DM,SH and DM+SH patients with diastolic dysfunction were much more than that in the control(30.3%),and had obviously differerance(p<0.05).Patients with pseudonormal filling in DM+SH group(33.3%)was the most,but no one in control.⑷Subset analysis: There were good positive correlation between Sm(the mitral annalas six points)and LVEF,and so as between mean Sm and LVEF(p<0.001).Among mitral annalas six points , the lateral(r=0.795, p<0.001) and the post saeptum(r=0.807, p<0.001) points had better correlation than others'. coefficient correlation of mean Sm and LVEF was 0.823.Mean E/Em of the mitral annalas six points had good positive correlation with LVEF(r=0.912,p<0.001).There was good positive correlation between left and right ventricular diastolic function parameter(Em,Em/Am)in DM group(p<0.001),and there were good positive correlation between Doppler diastolic function parameter on the outway of mitral valve and TDI's on left ventricular.Conclusion⑴Tere are diastolic dysfunction in patients with DM , even though no symptomatic heart failure;⑵SH may further worse LV diastolic dysfunction in patients with DM;⑶It dosen't show systolic dysfunction that DM patients with normal ejection fraction and without symptomatic heart failure; ⑷Left and right ventricular Tei indexes in patients with DM are bigger than them in normal ;⑸There is good positive correlation between Sm and LVEF, and Sm may be useful in prediction of early stolic dysfunction in patients with DM .
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