| Objectives:Myocardial damaging of diabetes mellitus mainly manifests as increased stiffness resulting from myocardial metabolic disorder and microvascular disease, which contributes to diastolic and systolic dysfunction, and likely portends greater risks of developing heart failure. Therefore, it's of great significance to detect the cardiac function of the patients with diabetes so as to allow clinical therapeutic trial in the early stage aimed at improving prognoses. There have been numerous technologies to research and evaluate the cardiac function of the diabetic previously, despite the limitations of themselves. In this article, we will use improved AMM, with the advantage of investigating the regional radial strain rate, acceleration and relative force in any direction, to assess the radial function of the patients with diabetes and try to recognize the feasibility and clinical value in the terms of evaluating diabetic cardiac function with the application of the parameters above.Machines& MethodsMachines:Application of vivid seven digital ultrasound system (GE VingMed Ultrasound) with the probe frequency of 1.7 to 3.5MHz and detection deepness of 15 to 18cm; Omin-directional M-mode echocardiography, which was developed by Biomedical Engineering Institute of Fuzhou University in China could detect the dynamic information based on the rebuilding their gray-time function of direction lines. Therefore, motional track, velocity and acceleration of given cardiac structure are available instantly through the system. And we also use EchoPac work station equipped with analytic software of speckle tracking imaging. Methods:1. Using improved AMM to evaluate radial strain rate at minor-axis of left ventricular: Twenty-six healthy volunteers (group HV) and twenty-seven patients (group DM) with type 2 diabetes mellitus were enrolled in this research. The radial strain rate of 6 segments at LV minor-axis papillary muscle level were measured by IAMM and speckle tracking imaging technology (STI), respectively, in the two groups above, and also assessed the correlations between two techniques, and differences of radial strain rate between the two groups.2. Using improved AMM to estimate acceleration and relative force during diastole and systole of regional myocardium at minor-axis of left ventricular papillary muscle in patients with diabetes:Patients were divided as the same groups as above. Collect the conventional echocardiographic index and calculate acceleration and relative force by IAMM, respectively. Then, these parameters above should be compared between the groups, within which the correlation should also be analyzed, and found out independent predictive factors of acceleration and relative force.3. Accessing the systolic synchrony of left ventricular at mid level by improved AMM: Patients were divided as the same groups as above. We got anatomic m-mode curves of six segments at mid level of left ventricular via IAMM. Measuring the time (T) to peak radial systolic movement of the above six segments from the onset of QRS and its standard deviation (T-6-sd), and the maximum difference (T-6-diff) as the indices of evaluating the systolic dyssynchrony of left ventricular. Comparing the difference of synchrony between the two groups and analyzing the relationships between indices of synchrony and the parameters of diastolic function.Results:1. There have been good correlations and agreements between the two technologies (r=0.87, p<0.05; r=0.93, p<0.05), and the minor-axis radial strain rate of group DM were lower in most of the segments during diastole than those of group HV (1.61±0.73vs2.07±0.83;162±0.75vs2.05±0.60;1.68±0.80vs2.20±0.61;1.69±0.83vs2.36±0.77;1.81 ±0.75vs2.55±1.14,P<0.05).2. Conventional echcardiographic index showed that the parameters reflecting diastolic function, E/A(PW), for example, were lower in group DM (0.81±0.11) were lower than those in group HV(1.29±0.26) (p<0.05);There had been a significant difference of acceleration and relative fore in most of minor-axis sections at papillary muscle plane between the two groups:group DM |
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