Evaluation of subclinical left ventricular myocardial systolic dysfunction in type 2 diabetes mellitus patients with and without diabetes peripheral neuropathy by global myocardial work

IF 3.1 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Acta Diabetologica Pub Date : 2023-10-19 DOI:10.1007/s00592-023-02197-7

Guang-An Li, Hui-Ling Bai, Jun Huang, Qi-Yong Wu, Li Fan

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Abstract

Aims

Speckle-tracking echocardiography can non-invasively estimate myocardial work (MW) to evaluate left ventricular (LV) myocardial systolic function. The present study evaluated whether MW may detect subclinical LV myocardial systolic dysfunction in type 2 diabetes mellitus (T2DM) patients with and without diabetes peripheral neuropathy (DPN).

Methods

A total of 127 T2DM patients were included in the present study, including 67 T2DM patients with DPN. In addition, 73 sex- and age- matched healthy individuals served as normal controls. The global myocardial work index (GWI), global constructive work (GCW), global waste work (GWW), global positive work (GPW), global negative work (GNW), global work efficiency (GWE) and GCW/GWW were measured and analysed. Furthermore, the differences in MW parameters among normal controls, T2DM patients, and T2DM patients with DPN were analysed. Multiple regression models were built to explore for the independent influencing factors of GWI and GPW values in T2DM patients with DPN. Receiver operating characteristic curve analysis was performed to evaluate the sensitivity and specificity of MW in evaluating subclinical LV myocardial systolic dysfunction in T2DM patients with DPN.

Results

The GWI, GCW and GPW of T2DM patients with DPN were significantly decreased compared with those of T2DM patients and normal controls (P < 0.001) and showed a significant decreasing trend overall (P _trend < 0.001). GWE and GCW/GWW were significantly decreased in T2DM patients with DPN compared with normal controls (P < 0.05). Although GWW was not significantly different among the three groups, it showed an increasing trend (P_trend = 0.033). High-density lipoprotein cholesterol (HDL-C) levels were independent influencing factor for decreased GWI (β = 0.21, P = 0.031) and GPW (β = 0.19, P = 0.043) values in T2DM patients with DPN. The combination of the GWI, GCW, GWE, GPW and GCW /GWW had good sensitivity (62.69%) and specificity (89.04%) when evaluating subclinical LV myocardial systolic dysfunction in T2DM patients with DPN.

Conclusions

Non-invasive evaluation of LV myocardial work can detect subclinical LV myocardial systolic dysfunction in T2DM patients with and without DPN. DPN has additive deleterious effects on LV myocardial systolic function in T2DM patients. The reduction of HDL-C levels may indicate the occurrence of subclinical LV myocardial systolic dysfunction in T2DM patients with DPN.

Abstract Image

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通过整体心肌工作评估伴有和不伴有糖尿病周围神经病变的2型糖尿病患者的亚临床左心室心肌收缩功能障碍。

目的：斑点跟踪超声心动图可以无创地估计心肌功（MW），以评估左心室（LV）心肌收缩功能。本研究评估了MW是否可以检测2型糖尿病（T2DM）伴有和不伴有糖尿病周围神经病变（DPN）的患者的亚临床左心室心肌收缩功能障碍。此外，73名性别和年龄匹配的健康人作为正常对照。测量并分析了全球心肌工作指数（GWI）、全球构造工作（GCW）、全球废物工作（GWW）、全局正工作（GPW）、全域负工作（GNW）、整体工作效率（GWE）和GCW/GWW。此外，还分析了正常对照组、T2DM患者和T2DM DPN患者MW参数的差异。建立多元回归模型，探讨2型糖尿病合并DPN患者GWI和GPW值的独立影响因素。结果：2型糖尿病合并DPN患者的GWI、GCW和GPW较2型糖尿病患者和正常对照组明显降低（P 趋势趋势 = 0.033）。高密度脂蛋白胆固醇（HDL-C）水平是GWI降低的独立影响因素（β = 0.21，P = 0.031）和GPW（β = 0.19，P = 0.043）值。GWI、GCW、GWE、GPW和GCW/GWW联合检测DPN的T2DM患者亚临床左心室收缩功能障碍具有良好的敏感性（62.69%）和特异性（89.04%）。DPN对T2DM患者的左心室心肌收缩功能具有加性有害影响。HDL-C水平的降低可能表明患有DPN的T2DM患者出现亚临床左心室心肌收缩功能障碍。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Diabetologica 医学-内分泌学与代谢

CiteScore

7.30

自引率

2.60%

发文量

180

审稿时长

2 months

期刊介绍： Acta Diabetologica is a journal that publishes reports of experimental and clinical research on diabetes mellitus and related metabolic diseases. Original contributions on biochemical, physiological, pathophysiological and clinical aspects of research on diabetes and metabolic diseases are welcome. Reports are published in the form of original articles, short communications and letters to the editor. Invited reviews and editorials are also published. A Methodology forum, which publishes contributions on methodological aspects of diabetes in vivo and in vitro, is also available. The Editor-in-chief will be pleased to consider articles describing new techniques (e.g., new transplantation methods, metabolic models), of innovative importance in the field of diabetes/metabolism. Finally, workshop reports are also welcome in Acta Diabetologica.