An Initial Study Of Left Intra-ventricular Diastolic Fluid Dynamics In Pre-diabetics Using Vector Flow Mapping

Objectives：The purposes of this study are to evaluate leftintra-ventricular diastolic blood flow patterns and fluid dynamics inpre-diabetics using vector flow mapping(VFM), and to explore the value ofleft intra-ventricular hydromechanics characteristics assessment ofintracardiac flow by VFM with more sensitive indexes.Methods:Forty-four patients with type 2 diabetes, twenty-eightpre-diabetes patients and thirty-three normal volunteers underwent VFM todetermine the left ventricular diastolic blood flow patterns and fluiddynamics. The two-dimensional color Doppler flow images data wereacquired in standerd apical four-chamber view during 3 complete cardiaccycles in aloka prosoundα-10，frame frequency is 30 f/s. These images wereanalyzed using a dedicated off-line workstation. At different level (mitralannulus，papillary muscl and apex level), the diastole blood flow parametersof LV including flow velocity and volume, velocity gradients(ΔV), pressuregradients(ΔP), diastole flow volume, vortex intensity(VI), vortex area(VA),vortex radius(VA) were derived. The differences of the above parameterswere compared among the three groups. The correlationship between diastolic function parameters and LV hydromechanics indexes wereanalyzed.Results:①C ompared to normal group and pre-diabetics group, the LVdiastolic function parameters E/A and e/a in diabetics group werelower(P<0.01), with no differences for E/e(P>0.05). There were nosignificant diffrences of these indices between diabetics group andpre-diabetics group(P>0.05).②Compared to normal group, theintraventricular peak flow velocity at basal level,ΔV andΔP in diabeticsgroup and pre-diabetics group were lower(P<0.01), but there were nosignificant differences of these indices between diabetics group andpre-diabetics group(P>0.05).③Compared to normal group, the diastolicpositive volume at basal level in diabetics group and pre-diabetics group waslower (P<0.01), but there was no significant differences of these indicesbetween diabetics group and pre-diabetics group(P>0.05).④Compared tothe normal group, the VI in diabetics and pre-diabetics group wasdecreased(P<0.01), but there were no significant differences of these indicesbetween diabetics group and pre-diabetics group(P>0.05); the VA and VR indiabetics and pre-diabetics group were increased, but there were nosignificant differences of these indices between diabetics group andpre-diabetics group(P>0.05).⑤There were no correlationship between diastolic function parameters and LV hydromechanics indexes.Conclusion: There is the same LV diastolic blood flow patterns andfluid dynamics existed in pre-diabetics as diabetics. VFM could be used as anew methods to demonstrate the early left intra-ventricular fluid dynamicsdamages in pre-diabetics patients .