Assessment Of Early Left Ventricular Strain By Three-dimensional Speckle Tracking Imaging And The Relationship With HbA1c In Type 2 Diabetes Mellitus

Objective:To quantitatively investigate the changes of left ventricular global longitudinal strain(GLS),global circumferential strain(GCS),global radial strain(GRS)and global twist angle(GTA)by three-dimensional speckle tracking imaging(3D-STI)in type 2 diabetes mellitus(T2DM),and to evaluate the changes of left ventricular myocardial strain and the correlation with HbA1 c in controlled HbA1c(HbA1c < 7%)and uncontrolled HbA1c(HbA1c?7%)conditions.Methods:We chose Forty-seven patients(age18-65 years,medical history?5years)diagnosed T2 DM in Department of Endocrinology,the Second Affiliated Hospital of Nanchang University from January to October in 2017,and divided into group A(HbA1c<7%)and group B(HbA1c?7%)according to HbA1 c levels.Twenty-seven healthy volunteers(age18-65 years)were selected as the control group C.The left ventricular global longitudinal strain(GLS),global radial strain(GRS),global circumferential strain(GCS)and left ventricular total twist angle(GTA)was analyzed by 3D-STI,then we compared the difference of left ventricular myocardial strain in different groups,and analyzed the correlation between HbA1 c and them.Result:Comparison of general clinical data shows that age,gender,body weight,height,body mass index(BMI)and blood lipids were not statistically significant between group A,group B,and group C(P>0.05).Two-dimensional echocardiographic data shows that left atrial(LA),left ventricular posterior wall end diastolic thickness(LVPWT),left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD)and left ventricular ejection fraction(LVEF)were not statistically significant between group A,group B,and group C(P>0.05).Compared with group C,interventricular septal end diastolic thickness(IVST)were significantly thickened in group A and B(P < 0.05),but there was no significant difference between group A and group B(P>0.05).A values were significantly increased in group A and B(P < 0.05),and group A increased more compared with group B(P < 0.05).E and E/A values were significantly decreased in group A and B(P < 0.05),and group B decreased more compared with group A(P < 0.05).3D-STI data shows that LVEDV,LVESV and GTA had no significant changes(P>0.05).Compared with group C,3D-EF?GLS?GCS?GRS were significantly decreased in group A and B(P < 0.05),and 3D-EF,GLS decreased more in group B.Also,there was no significant change of GCS and GRS between group A and B.HbA1c was associated with GLS(r=-0.46)?GCS(r=-0.35)?GRS(r=-0.42)?3D-EF(r=-0.45)(P<0.01).Conclusion:1.Interventricular septum was relatively thickened in early period of T2 DM,and diastolic function has also damaged.The degree of damage is related to the control of blood glucose.2.3D-STI can quantitatively analyze the left ventricular systolic dysfunction in T2 DM.It is more sensitive and comprehensive than the conventional two-dimensional echocardiography to detect early changes of the myocardium.GLS is a sensitive index.3.The degree of early left ventricular regional systolic dysfunction is associated with the level of HbA1 c in patients with type 2 diabetes.