Research On Evaluating Left Ventricular Systolic Function In Type 2 Diabetes Mellitus Patients By Real-time Three-dimensional Echocardiography

Objective:1. To measure the Systolic function and regional systolic function of left ventricular in patients with type 2 diabetes mellitus of different stages by using real-time three-dimensional echocardiography technique(RT-3DE). 2. To explore the contribution of cardiac damage in patients with type 2 Diabetes Mellitus by using real-time three-dimensional echocardiography technique.Methods:60 cases of patients and 30 cases of healthy volunteers underwent M-mode ultrasound and real-time three-dimensional echocardiography inspection. All 60 patients were included according to diagnostic criteria by 1999 WHO diabetes expert committee that current widespread use. Patients with type 2 diabetes mellitus were divided into diabetes mellitus group(B1 group) and diabetes mellitus with microangiopathy group(B2 group),and health adults were selected as normal control(A group). All were taken to the subject were exposed to the chest、 caught the left lateral position, and a synchronous connection electrocardiogram. To measure left ventricular ejection fraction with M-mode ultrasound under the two-dimensional ultrasound mode, Store four consecutive cardiac cycles under full of volume three-dimensional imaging mode in the hard disk. To obtain left ventricular capacity-time curve and describe the calculation of the left ventricle in 17 segment by Qlab(6.0) technology. Using RT-3DE technique measure Left ventricular ejection fraction(LVEF) and the standard deviation, the maximal difference of the time to the point with minimal systolic volume of 16,12,6 segments(Tmsv16,12,6-SD,Tmsv16,12,6-Dif) and heart rate correction value(Tmsv16,12,6-SD%, Tmsv16,12,6-Dif%). Results:Two groups in average age, heart rate, blood pressure, etc. not have significance(P>0.05).The LVEF by conventional M-mode ultrasound measurement of each group were within the normal range(LVEF>50%). Among the groups, the difference was not statistically significant(P>0.05).The LVEF of normal control group and diabetic group alone is within the normal range. LVEF of microangiopathy group that some in the normal range. Compared to the normal control group the cases of heart failure patients were lower, and the microangiopathy more obvious(P<0.05).M-mode ultrasound measurement the RT-3DE’s measurement were lower(P<0.05).Compared to the normal control group that Tmsv16、12、6-SD,Tmsv16、12、6-Dif, Tmsv16、12、6-SD%,Tmsv16、12、6-Dif%, the cases of patients were higher, and the microangiopathy more obvious(P<0.05). Conclusion:DM patients with LVEF in conventional echocardiography in the normal range. Reducing the DM’s LVEF in time three-dimensional echocardiography, and even some not within the normal range. This explains that RT-3DE can earlier abnormal left ventricular systolic function than conventional echocardiography.With increasing severity of the disease in patients with diabetes, left ventricular systolic function decreased.DM patients with left ventricular systolic function first appeared abnormal, then there systolic dysfunction.To evaluate left ventricular systolic function and localized in different periods in patients with type 2 DM by using RT-3DE to that overcome the shortcomings of conventional echocardiography can accurately measure the contraction of each segment. RT-3DE providing a basis for the assessment of cardiac damage early.