Accessmenet Of Left Ventricular Function And Synchrony In Patients With Type 2 Diabetes And Metabolic Syndrome Using Real-time Three-dimensional Echocardiography

Objective To evaluate left ventricular function and synchrony with real-time three- dimensional echocardiography(RT-3DE) in patients with type 2 diabetes(T2DM) and metabolic syndrome(MS), and explore the correlation between MS criteria and left ventricular ejection fraction detected by RT-3DE(3D-EF) and systolic dyssynchrony index(SDI).Methods 95 patients were divided into three groups according to the international diabetes foundation(IDF) criteria and the diagnostic criteria of T2 DM, namely:MS without T2DM、T2DM without MS、MS with T2 DM.And 40 healthy volunteers were enrolled as normal controls.Measure baseline clinical characteristics of all subjects,such as waist circumference(WC)、systolic blood pressure(SBP)、fasting blood-glucose( FBG) 、 triglycerides( TG) 、 high-density lipoprotein cholesterol(HDL-C).The full-vulume images of left ventricular are recorded and analyzed by RT-3DE analysis software. Left ventricular end-diastolic volume(EDV), end-systolic volume(ESV), 3D-EF and synchronicparameters(Tmsv16-SD%、Tmsv12-SD%、Tmsv6-SD%、Tmsv16-Dif%、Tmsv12-Dif%、Tmsv6-Dif%) were calculated.Among them Tmsv16-SD%is SDI.Results Compared with the control group,ESV、Tmsv16-SD%,Tmsv12-SD%, Tmsv6-SD%, Tmsv16-Dif%, Tmsv12-Dif% in MS without T2 DM, T2 DM without MS, MS with T2 DM increased,3D-EF decreased(P<0.05). Compared with MS without T2 DM and T2 DM without MS,Tmsv16-SD%, Tmsv12-SD%, Tmsv16-Dif%, Tmsv6-Dif% in MS with T2 DM increased, 3D-EF decreased(P<0.05). Among MS without T2 DM and T2 DM without MS,RT-3DE parameters have no statistical differences(P>0.05).waist circumference(WC), systolic blood pressure(SBP), fasting blood-glucose(FBG) and 3D-EF(r=-0.57、-0.52、-0.46, P<0.05) were negatively correlated,and positively correlated with SDI(r=0.48、0.63、0.55,P<0.05).Conclusion RT-3DE can assess left ventricular funtion and synchrony in patients with T2 DM and MS sensitively. Patients having MS without T2 DM and T2 DM without MS exhibited a similar impairment of left ventricular function and synchrony, whereas patients with MS and T2 DM have a further deterioration.WC、SBP、FBG are MS criteria with the strongest impact on LV function and synchrony.