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Diabetes is associated with impaired myocardial performance in patients without significant coronary artery disease.

Andersson C, Gislason GH, Weeke P, Hoffmann S, Hansen PR, Torp-Pedersen C, Søgaard P - Cardiovasc Diabetol (2010)

Bottom Line: In multivariable regression analyses, DM remained significantly associated with impairments of S' and E', respectively.In patients without significant CAD, DM is associated with an impaired systolic longitudinal LV function and global diastolic dysfunction.These abnormalities are likely to be markers of adverse prognosis.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Cardiology, Gentofte Hospital, University of Copenhagen, Denmark. ca@heart.dk

ABSTRACT

Background: Patients with diabetes mellitus (DM) have high risk of heart failure. Whether some of the risk is directly linked to metabolic derangements in the myocardium or whether the risk is primarily caused by coronary artery disease (CAD) and hypertension is incompletely understood. Echocardiographic tissue Doppler imaging was therefore performed in DM patients without significant CAD to examine whether DM per se influenced cardiac function.

Methods: Patients with a left ventricular (LV) ejection fraction (EF) > 35% and without significant CAD, prior myocardial infarction, cardiac pacemaker, atrial fibrillation, or significant valve disease were identified from a tertiary invasive center register. DM patients were matched with controls on age, gender and presence of hypertension.

Results: In total 31 patients with diabetes and 31 controls were included. Mean age was 58 +/- 12 years, mean LVEF was 51 +/- 7%, and 48% were women. No significant differences were found in LVEF, left atrial end systolic volume, or left ventricular dimensions. The global longitudinal strain was significantly reduced in patients with DM (15.9 +/- 2.9 vs. 17.7 +/- 2.9, p = 0.03), as were peak longitudinal systolic (S') and early diastolic (E') velocities (5.7 +/- 1.1 vs. 6.4 +/- 1.1 cm/s, p = 0.02 and 6.1 +/- 1.7 vs. 7.7 +/- 2.0 cm/s, p = 0.002). In multivariable regression analyses, DM remained significantly associated with impairments of S' and E', respectively.

Conclusion: In patients without significant CAD, DM is associated with an impaired systolic longitudinal LV function and global diastolic dysfunction. These abnormalities are likely to be markers of adverse prognosis.

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Related in: MedlinePlus

Individual plot of mean peak systolic (S'), early diastolic (E') and atrial (A') velocities according to diabetes (DM) status. All values are measured from the three apical views at both sides of the mitral annulus level (in total six segments).
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Figure 1: Individual plot of mean peak systolic (S'), early diastolic (E') and atrial (A') velocities according to diabetes (DM) status. All values are measured from the three apical views at both sides of the mitral annulus level (in total six segments).

Mentions: Figure 1 illustrates the peak longitudinal systolic, early diastolic and atrial tissue velocities in patients with and without DM. Mean S' and E' were significantly lower in patients with DM, compared to controls (5.7 ± 1.1 vs. 6.4 ± 1.1 cm/s, p = 0.02 and 6.1 ± 1.7 vs. 7.7 ± 2.0 cm/s, p = 0.002).


Diabetes is associated with impaired myocardial performance in patients without significant coronary artery disease.

Andersson C, Gislason GH, Weeke P, Hoffmann S, Hansen PR, Torp-Pedersen C, Søgaard P - Cardiovasc Diabetol (2010)

Individual plot of mean peak systolic (S'), early diastolic (E') and atrial (A') velocities according to diabetes (DM) status. All values are measured from the three apical views at both sides of the mitral annulus level (in total six segments).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2818623&req=5

Figure 1: Individual plot of mean peak systolic (S'), early diastolic (E') and atrial (A') velocities according to diabetes (DM) status. All values are measured from the three apical views at both sides of the mitral annulus level (in total six segments).
Mentions: Figure 1 illustrates the peak longitudinal systolic, early diastolic and atrial tissue velocities in patients with and without DM. Mean S' and E' were significantly lower in patients with DM, compared to controls (5.7 ± 1.1 vs. 6.4 ± 1.1 cm/s, p = 0.02 and 6.1 ± 1.7 vs. 7.7 ± 2.0 cm/s, p = 0.002).

Bottom Line: In multivariable regression analyses, DM remained significantly associated with impairments of S' and E', respectively.In patients without significant CAD, DM is associated with an impaired systolic longitudinal LV function and global diastolic dysfunction.These abnormalities are likely to be markers of adverse prognosis.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Cardiology, Gentofte Hospital, University of Copenhagen, Denmark. ca@heart.dk

ABSTRACT

Background: Patients with diabetes mellitus (DM) have high risk of heart failure. Whether some of the risk is directly linked to metabolic derangements in the myocardium or whether the risk is primarily caused by coronary artery disease (CAD) and hypertension is incompletely understood. Echocardiographic tissue Doppler imaging was therefore performed in DM patients without significant CAD to examine whether DM per se influenced cardiac function.

Methods: Patients with a left ventricular (LV) ejection fraction (EF) > 35% and without significant CAD, prior myocardial infarction, cardiac pacemaker, atrial fibrillation, or significant valve disease were identified from a tertiary invasive center register. DM patients were matched with controls on age, gender and presence of hypertension.

Results: In total 31 patients with diabetes and 31 controls were included. Mean age was 58 +/- 12 years, mean LVEF was 51 +/- 7%, and 48% were women. No significant differences were found in LVEF, left atrial end systolic volume, or left ventricular dimensions. The global longitudinal strain was significantly reduced in patients with DM (15.9 +/- 2.9 vs. 17.7 +/- 2.9, p = 0.03), as were peak longitudinal systolic (S') and early diastolic (E') velocities (5.7 +/- 1.1 vs. 6.4 +/- 1.1 cm/s, p = 0.02 and 6.1 +/- 1.7 vs. 7.7 +/- 2.0 cm/s, p = 0.002). In multivariable regression analyses, DM remained significantly associated with impairments of S' and E', respectively.

Conclusion: In patients without significant CAD, DM is associated with an impaired systolic longitudinal LV function and global diastolic dysfunction. These abnormalities are likely to be markers of adverse prognosis.

Show MeSH
Related in: MedlinePlus