Changs Of Heart Structure And Function In Patients With Type 2 Diabetes Mellitus

Background and Objective The prevalence of diabetes mellitus in the world is increasing year by year,and cardiovascular disease is the leading cause of death in patients with type 2 diabetes mellitus.Studies had shown that type 2 diabetes mellitus can lead to the changes of heart structure and function in the early stages.At present,the mechanism of changes about cardiac structure and function in T2 DM patients has not clear yet,and there are many influencing factors.This study mainly to compare the cardiac ultrasound results between T2 DM patients and healthy persons and patients that in different stages of T2 DM,to study the characteristics of heart structure and function in patients with type 2 diabetes mellitus and analyze the influencing factors.Object and Method 487 cases(T2DM group)of T2 DM patients admitted to the department of endocrinology,First Affiliated Hospital of Zhengzhou University from January 2016 to December 2016 were selected.They were not accompanied by coronary heart disease,hypertension and so on.In addition,140 healthy persons were selected as control group.We compare the results of echocardiography and analyze the influencing factors of heart structure and function in patients with T2 DM.The T2DM patients are grouped according to the diabetes course,and we compare the heart structure and function of these groups.Results Pulmonary arterial diameter(PA),interventricular septal thickness(IVSTd),left atrial dimension(LAD)and left ventricular posterior wall thickness(LPWTd)increased in T2 DM group compared with control group(P<0.05);There are no significant difference between the two group about the left ventricular diameter(LVIDd),right ventricular diameter(RVIDd)and right atrial area(RA-A);E peak,E/A value and left ventricular ejection fraction(LVEF %)of T2 DM group decreased significantly compared with control group(P < 0.05).There are not significant changes in heart structure of different groups.IVSTd,LPWTd,LAD,PA increased in the group ?5 years compared with control group(P<0.05).There are not significant difference between the group ?5 years and the control group about LVIDd,RVIDd,RA-A(P > 0.05);E peak,E/A value and LVEF % decreased significantly compared with the control group(P<0.05).E/A value of group 5-10 years decreased significantly compared with the group ?5 years,E/A value of group 10-15 years decreased significantly compared with the group ?5 years,E peak and E/A value of group 15-30 years decreased significantly compared with the group ?5 years,LVEF % of group 15-30 years decreased significantly compared with other groups.IVSTd is significantly correlated with diastolic pressure,body mass index(BMI),diabetes course,serum creatinine(Cr),24 hours urine microalbumin(24h UAlb),intima-media thickness(IMT).LPWTd is significantly correlated with diastolic pressure,BMI,Cr,serum uric acid(UA),24 h UAlb,IMT.LAD is significantly correlated with age,BMI,24 h UAlb,Homa-IR(CP),IMT,HDL-C.There are no correlation with fasting plasma glucose,glycosylated hemoglobin and triglycerides.The diabetes course and diastolic pressure are the influencing factors of IVSTd.The diabetes course is the influencing factor of LPWTd.BMI and age are the influencing factors of LAD.A peak,E peak and E/A value are significantly correlated with age and diabetes course.LVEF% is correlated with NT-pro BNP.The age is the influencing factor of A peak,E peak and E/A value.Conclusion The changes of heart structure in T2 DM patients occur in the early stage and mainly manifested in the left ventricular hypertrophy,the enlargement of the left atrium and pulmonary artery.There are no significant changs with the disease progression.The changes of heart function in T2 DM patients occur in the early stage and mainly manifested in the contraction and diastolic dysfunction,with the disease progression,the diastolic function decreased significantly.