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Tissue Doppler imaging is a sensitive echocardiographic technique to detect subclinical systolic and diastolic dysfunction of both ventricles in type 1 diabetes mellitus.
BMC Cardiovasc Disord. 2016 Apr 22; 16:72.BC

Abstract

BACKGROUND

Subclinical left (LV) and right ventricular (RV) dysfunction has been demonstrated in type 2 diabetes mellitus and evidence indicates impaired LV diastolic function in type 1 diabetes mellitus (T1DM) as well. The aim of our study was to evaluate the role of tissue Doppler imaging (TDI) in assessment of global LV and RV function in T1DM patients.

METHODS

A detailed two-dimensional, pulsed wave Doppler and pulsed wave TDI analysis was performed in 53 normotensive middle-aged T1DM patients and compared to healthy controls.

RESULTS

In T1DM patients TDI analysis revealed reduced mean mitral septal and lateral E' velocities as well as reduced mean tricuspid E˙t velocity compared to healthy controls (E'sept 8.89 ± 1.89 cm/s vs. 11.50 ± 2.41 cm/s, p < 0.001; E'lat 12.29 ± 2.58 cm/s vs.15.30 ± 2.95 cm/s, p < 0,001; E't 13.56 ± 2.91 cm/s vs. 15.60 ± 2.99 cm/s, p = 0.001). Mean ratios E/E'sept, E/E'lat and E/E't were significantly higher in diabetics with cutoff value of 7.4 for E/E'sept and 3.4 for E/E't, differentiating diabetics with LV and RV diastolic impairement from matched healthy controls (sensitivity 76.5 %, specificity 73.8 % for E/E'sept and sensitivity 72.1 %, specificity 66.7 % for E/E't). Myocardial acceleration during isovolumetric contraction (IVA) measured at the septal mitral (LV IVA) and lateral tricuspid annulus (RV IVA) was the only parameter indicating reduced contractility of both ventricles in diabetics compared to controls (LV IVA 230.70 ± 61.26 cm/s(2) vs. 283.32 ± 59.74 cm/s(2), p < 0,001; RV IVA 275.48 ± 68.08 cm/s(2) vs. 316.86 ± 80.95 cm/s(2), p = 0.011). LV IVA had better diagnostic accuracy than RV IVA to predict early contractile impairement in T1DM patients (area under the curve 0.758, p < 0.001 for LV IVA and 0.648, p = 0.017 for RV IVA).

CONCLUSIONS

TDI is essential to detect subclinical diastolic deterioration of both ventricles in T1DM patients. TDI-derived IVA might be useful to assess early systolic alterations of both ventricles in T1DM patients.

Authors+Show Affiliations

Department of Cardiology and Angiology, Clinic for Internal Medicine, University Medical Centre Maribor, Ljubljanska ulica 5, 2000, Maribor, Slovenia. david.suran@hotmail.com.Department of Medical Intensive Care, Clinic for Internal Medicine, University Medical Centre Maribor, Ljubljanska ulica 5, 2000, Maribor, Slovenia.Department of Cardiology and Angiology, Clinic for Internal Medicine, University Medical Centre Maribor, Ljubljanska ulica 5, 2000, Maribor, Slovenia.

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

27102111

Citation

Suran, David, et al. "Tissue Doppler Imaging Is a Sensitive Echocardiographic Technique to Detect Subclinical Systolic and Diastolic Dysfunction of Both Ventricles in Type 1 Diabetes Mellitus." BMC Cardiovascular Disorders, vol. 16, 2016, p. 72.
Suran D, Sinkovic A, Naji F. Tissue Doppler imaging is a sensitive echocardiographic technique to detect subclinical systolic and diastolic dysfunction of both ventricles in type 1 diabetes mellitus. BMC Cardiovasc Disord. 2016;16:72.
Suran, D., Sinkovic, A., & Naji, F. (2016). Tissue Doppler imaging is a sensitive echocardiographic technique to detect subclinical systolic and diastolic dysfunction of both ventricles in type 1 diabetes mellitus. BMC Cardiovascular Disorders, 16, 72. https://doi.org/10.1186/s12872-016-0242-2
Suran D, Sinkovic A, Naji F. Tissue Doppler Imaging Is a Sensitive Echocardiographic Technique to Detect Subclinical Systolic and Diastolic Dysfunction of Both Ventricles in Type 1 Diabetes Mellitus. BMC Cardiovasc Disord. 2016 Apr 22;16:72. PubMed PMID: 27102111.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tissue Doppler imaging is a sensitive echocardiographic technique to detect subclinical systolic and diastolic dysfunction of both ventricles in type 1 diabetes mellitus. AU - Suran,David, AU - Sinkovic,Andreja, AU - Naji,Franjo, Y1 - 2016/04/22/ PY - 2015/12/01/received PY - 2016/04/08/accepted PY - 2016/4/23/entrez PY - 2016/4/23/pubmed PY - 2016/12/15/medline KW - Diabetes mellitus type 1 KW - Left ventricular dysfunction KW - Right ventricular dysfunction KW - Tissue Doppler imaging SP - 72 EP - 72 JF - BMC cardiovascular disorders JO - BMC Cardiovasc Disord VL - 16 N2 - BACKGROUND: Subclinical left (LV) and right ventricular (RV) dysfunction has been demonstrated in type 2 diabetes mellitus and evidence indicates impaired LV diastolic function in type 1 diabetes mellitus (T1DM) as well. The aim of our study was to evaluate the role of tissue Doppler imaging (TDI) in assessment of global LV and RV function in T1DM patients. METHODS: A detailed two-dimensional, pulsed wave Doppler and pulsed wave TDI analysis was performed in 53 normotensive middle-aged T1DM patients and compared to healthy controls. RESULTS: In T1DM patients TDI analysis revealed reduced mean mitral septal and lateral E' velocities as well as reduced mean tricuspid E˙t velocity compared to healthy controls (E'sept 8.89 ± 1.89 cm/s vs. 11.50 ± 2.41 cm/s, p < 0.001; E'lat 12.29 ± 2.58 cm/s vs.15.30 ± 2.95 cm/s, p < 0,001; E't 13.56 ± 2.91 cm/s vs. 15.60 ± 2.99 cm/s, p = 0.001). Mean ratios E/E'sept, E/E'lat and E/E't were significantly higher in diabetics with cutoff value of 7.4 for E/E'sept and 3.4 for E/E't, differentiating diabetics with LV and RV diastolic impairement from matched healthy controls (sensitivity 76.5 %, specificity 73.8 % for E/E'sept and sensitivity 72.1 %, specificity 66.7 % for E/E't). Myocardial acceleration during isovolumetric contraction (IVA) measured at the septal mitral (LV IVA) and lateral tricuspid annulus (RV IVA) was the only parameter indicating reduced contractility of both ventricles in diabetics compared to controls (LV IVA 230.70 ± 61.26 cm/s(2) vs. 283.32 ± 59.74 cm/s(2), p < 0,001; RV IVA 275.48 ± 68.08 cm/s(2) vs. 316.86 ± 80.95 cm/s(2), p = 0.011). LV IVA had better diagnostic accuracy than RV IVA to predict early contractile impairement in T1DM patients (area under the curve 0.758, p < 0.001 for LV IVA and 0.648, p = 0.017 for RV IVA). CONCLUSIONS: TDI is essential to detect subclinical diastolic deterioration of both ventricles in T1DM patients. TDI-derived IVA might be useful to assess early systolic alterations of both ventricles in T1DM patients. SN - 1471-2261 UR - https://www.unboundmedicine.com/medline/citation/27102111/Tissue_Doppler_imaging_is_a_sensitive_echocardiographic_technique_to_detect_subclinical_systolic_and_diastolic_dysfunction_of_both_ventricles_in_type_1_diabetes_mellitus_ L2 - https://bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-016-0242-2 DB - PRIME DP - Unbound Medicine ER -