评估患有和未患有外周血管疾病的 2 型糖尿病患者的左心室收缩功能

IF 4.2 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

World Journal of Diabetes Pub Date : 2024-06-15 DOI:10.4239/wjd.v15.i6.1280

Guang-an Li, Jun Huang, Li Fan

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引用次数: 0

摘要

背景外周血管疾病（PVD）是 2 型糖尿病（T2DM）的常见并发症。T2DM 患者发生 PVD 的风险是非糖尿病患者的两倍。目的通过特异性全层纵向应变（GLS）和峰值应变弥散（PSD）评估有和无 PVD 的 T2DM 患者的左心室收缩功能。方法该研究共纳入 65 名无 PVD 的 T2DM 患者、57 名有 PVD 的 T2DM 患者和 63 名正常对照组。研究人员计算了各层特异性 GLS [心外膜 GLS (GLSepi)、心肌中层 GLS (GLSmid) 和心内膜 GLS (GLSendo)]和 PSD。通过接收者操作特征（ROC）分析计算 T2DM 患者左心室收缩功能障碍的敏感性和特异性。我们计算了生化数据、超声心动图特征以及特异层 GLS 和 PSD 之间的皮尔逊相关系数。结果正常对照组、无心血管畸形的 T2DM 患者和有心血管畸形的 T2DM 患者之间的 GLSepi、GLSmid 和 GLSendo 存在明显差异（P < 0.001）。趋势检验显示，GLS绝对值的排序为正常对照组>无心血管病变的T2DM患者>有心血管病变的T2DM患者（P<0.001）。三组间的 PSD 有明显差异，趋势排序为：正常对照组 < 无 PVD 的 T2DM 患者 < 有 PVD 的 T2DM 患者（P < 0.001）。ROC分析显示，结合特异层GLS和PSD检测T2DM心血管病患者的左心室收缩功能障碍具有很高的诊断效率。低密度脂蛋白胆固醇与GLSepi、GLSmid和PSD呈正相关（P＜0.05），而T2DM心血管病患者的左心室射血分数与GLSepi、GLSmid和GLSendo呈负相关（P＜0.01）。结论 PVD可能会加重T2DM患者左心室收缩功能障碍的恶化。分层特异性 GLS 和 PSD 可用于准确、方便地检测有或没有 PVD 的 T2DM 患者的左心室收缩功能障碍。

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Evaluation of left ventricular systolic function in type 2 diabetes mellitus patients with and without peripheral vascular disease

BACKGROUND Peripheral vascular disease (PVD) is a common complication of type 2 diabetes mellitus (T2DM). Patients with T2DM have twice the risk of PVD as nondiabetic patients. AIM To evaluate left ventricular (LV) systolic function by layer-specific global longitudinal strain (GLS) and peak strain dispersion (PSD) in T2DM patients with and without PVD. METHODS Sixty-five T2DM patients without PVD, 57 T2DM patients with PVD and 63 normal controls were enrolled in the study. Layer-specific GLS [GLS of the epimyocardium (GLSepi), GLS of the middle myocardium (GLSmid) and GLS of the endocardium (GLSendo)] and PSD were calculated. Receiver operating characteristic (ROC) analysis was performed to calculate the sensitivity and specificity of LV systolic dysfunction in T2DM patients with PVD. We calculated Pearson’s correlation coefficients between biochemical data, echocardiographic characteristics, and layer-specific GLS and PSD. RESULTS There were significant differences in GLSepi, GLSmid and GLSendo between normal controls, T2DM patients without PVD and T2DM patients with PVD (P < 0.001). Trend tests revealed a ranking of normal controls > T2DM patients without PVD > T2DM patients with PVD in the absolute value of GLS (P < 0.001). PSD differed significantly between the three groups, and the trend ranking was as follows: normal controls < T2DM patients without PVD < T2DM patients with PVD (P < 0.001). ROC analysis revealed that the combination of layer-specific GLS and PSD had high diagnostic efficiency for detecting LV systolic dysfunction in T2DM patients with PVD. Low-density lipoprotein cholesterol was positively correlated with GLSepi, GLSmid and PSD (P < 0.05), while LV ejection fraction was negatively correlated with GLSepi, GLSmid and GLSendo in T2DM patients with PVD (P < 0.01). CONCLUSION PVD may aggravate the deterioration of LV systolic dysfunction in T2DM patients. Layer-specific GLS and PSD can be used to detect LV systolic dysfunction accurately and conveniently in T2DM patients with or without PVD.

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来源期刊

World Journal of Diabetes ENDOCRINOLOGY & METABOLISM-

自引率

2.40%

发文量

909

期刊介绍： The WJD is a high-quality, peer reviewed, open-access journal. The primary task of WJD is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of diabetes. In order to promote productive academic communication, the peer review process for the WJD is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJD are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in diabetes. Scope: Diabetes Complications, Experimental Diabetes Mellitus, Type 1 Diabetes Mellitus, Type 2 Diabetes Mellitus, Diabetes, Gestational, Diabetic Angiopathies, Diabetic Cardiomyopathies, Diabetic Coma, Diabetic Ketoacidosis, Diabetic Nephropathies, Diabetic Neuropathies, Donohue Syndrome, Fetal Macrosomia, and Prediabetic State.