Assessment Of Left Ventricular Systolic Function In Type2Diabetes Mellitus Patients With Three-Dimensional Speckle Tracking Echocardiography

ObjectiveTo assess left ventricular systolic function in type2diabetes mellitus (T2DM) patients with cardiomyopathy during the subclinical stage by use three-dimensional speckle tracking echocardiography (3D-STE), and to explore the correlation between three-dimensional strain (3DS), longitudinal strain (LS), circumferential strain (CS) and left ventricular ejection fraction (LVEF), as well as the correlation between3DS, LS, CS and glycosylated hemoglobin (HbAlc).Methods53patients with T2DM and30normal control (group NC) were enrolled, patients were divided into diabetic mellitus group (group A,n=30) and diabetic mellitus with microangiopathy group (group B, n=23). Three-dimensional imagines of left ventricular were obtained for all the individuals, and then used TomTec4D LV analysis software to calculate3DS, LS and CS of16segments. Took the absolute value to analysis the correlation with LVEF and with HbAlc after averaging the3DS, LS, CS of the16segments,Results1. In NC group, the3DS in apical and middle part of anteroseptal, inferior wall and septum were significantly higher than basal part (P<0.05); the3DS in middle part of posterior wall was significantly higher than basal part(P<0.05); the3DS in apical part of inferior wall was significantly higher than middle part(P<0.05).In NC group, the LS in apical part of inferior wall and septum were significantly higher than middle and basal part (P<0.05); the LS in apical part of lateral wall was significantly higher than basal part (P<0.05)In NC group, the CS in apical and middle part of anteroseptal, inferior wall and septum were significantly higher than basal part (P<0.05); the CS in middle part of anterior wall was significantly higher than basal part(P<0.05)2. Compared with group NC, the3DS of group A and B were significantly lower (P<0.05) in the middle and apical part of anteroseptal and lateral wall, also in the middle and basal part of posterior wall; the3DS of group A in the basal part of lateral wall were lower (P<0.05), of group B in the middle part of anterior wall as well as in the middle and apical part of septum were lower (P<0.05).Compared with group NC, the LS of group A and B were significantly lower (P<0.05) in the middle part of anteroseptal, anterior wall, posterior wall, and also in the apical part of septum; the LS of group B in the apical part of anteroseptal, in the middle and apical part of lateral wall, in the apical part of inferior wall were lower (P<0.05).Compared with group NC, the CS of group A and B were significantly lower (P<0.05) in the basal、middle and apical parts of anterior wall, also in the middle and basal parts of posterior wall; the CS of group A in the basal part of lateral wall was lower (P<0.05), of group B in the middle part of anteroseptal, as well as in the middle and basal parts of septum were lower (P<0.05). 3. The absolute value of3DS, LS, CS and LVEF were positively correlated, the correlation coefficients respectively were0.75(3DS),0.61(LS),0.71(CS), P<0.01.4. The absolute value of3DS, LS, CS and HbAlc were negatively correlated, the correlation coefficients respectively were-0.42(3DS),-0.29(LS),-0.36(CS), P<0.01Conclusion1.3D-STE is a simple, reliable, repeatable new technique, has high value in evaluation of left ventricular dynamics in diabetes;2. Compared with LVEF,3DS, CS, LS are more sensitive to reflect the left ventricular systolic dysfunction in type2diabetes mellitus patients;3.3DS,CS,LS and left ventricular systolic function are positively correlated, Compared with CS and LS,3DS is more objective and scientific to reflect the actual motion trajectory and deformation of left ventricular, it has high application value to assess the left ventricular function dysfunction which caused by diabetic cardiomyopathy.4. HbAlc and left ventricular systolic function are negatively correlated, HbAlc has certain reference value in the evaluation of left ventricular function dysfunction in type2diabetes mellitus patients.