Tags

Type your tag names separated by a space and hit enter

Impact of acute hyperglycemia on layer-specific left ventricular strain in asymptomatic diabetic patients: an analysis based on two-dimensional speckle tracking echocardiography.
Cardiovasc Diabetol. 2019 06 03; 18(1):68.CD

Abstract

BACKGROUND

Hyperglycemia has detrimental effect on ischemic myocardium, but the impact of acute hyperglycemia on the myocardium in asymptomatic diabetic patients has not been fully elucidated. Thus, this follow-up study was aimed to investigate the effects and reversibility of acute hyperglycemia on regional contractile function of left ventricle (LV) in diabetic patients without cardiovascular disease.

METHODS

The two-dimensional speckle tracking echocardiography (2D-STE), including multilayer strain analysis, was used for evaluation of global and regional LV function in asymptomatic, normotensive patients with uncomplicated diabetes, with acute hyperglycemia (≥ 11.1 mmol/l) (Group A, n = 67), or with optimal metabolic control (fasting plasma glucose < 7 mmol/l and HbA1c < 7%) (Group B, n = 20), while 20 healthy individuals served as controls (Group C). In group A, after 72 h of i.v. continuous insulin treatment (at the time euglycemia was achieved) (second examination) and after 3 months following acute hyperglycemia (third examination) 2D-STE was repeated.

RESULTS

Global longitudinal strain (GLS) (- 19.6 ± 0.4%) in Group A was significantly lower in comparison to both groups B (- 21.3 ± 0.4%; p < 0.05) and C (- 21.9 ± 0.4%; p < 0.01) at baseline, while we could not detect the differences between groups B and C. Peak systolic longitudinal endocardial (Endo), mid-myocardial (Mid) and epicardial (Epi) layer strain were significantly lower in group A at baseline compared to both groups B and C. Deterioration in peak systolic circumferential strain was observed at basal LV level, in all three layers (Endo, Mid and Epi) and in mid-cavity LV level in Epi layer in group A in comparison to group C. Moreover, in group A, after euglycemia was achieved (at second and third examination) GLS, as well as peak longitudinal and circumferential strain remain the same.

CONCLUSION

Acute hyperglycemia in asymptomatic diabetic patients has significant negative effects on systolic LV myocardial mechanics primarily by reducing GLS and multilayer peak systolic longitudinal and circumferential strain which was not reversible after three months of good glycemic control.

Authors+Show Affiliations

Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, dr Subotića 13, Belgrade, 11000, Serbia.Faculty of Medicine, University of Belgrade, dr Subotića 8, Belgrade, 11000, Serbia. Clinic for Cardiology, Clinical Center of Serbia, Pasterova 2, Belgrade, 11000, Serbia.Faculty of Medicine, University of Belgrade, dr Subotića 8, Belgrade, 11000, Serbia. Clinic for Cardiology, Clinical Center of Serbia, Pasterova 2, Belgrade, 11000, Serbia.Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, dr Subotića 13, Belgrade, 11000, Serbia. Faculty of Medicine, University of Belgrade, dr Subotića 8, Belgrade, 11000, Serbia.Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, dr Subotića 13, Belgrade, 11000, Serbia. Faculty of Medicine, University of Belgrade, dr Subotića 8, Belgrade, 11000, Serbia.Center for Medical Biochemistry, Clinical Center of Serbia, Pasterova 2, Belgrade, 11000, Serbia.Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, dr Subotića 13, Belgrade, 11000, Serbia. Faculty of Medicine, University of Belgrade, dr Subotića 8, Belgrade, 11000, Serbia.Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, dr Subotića 13, Belgrade, 11000, Serbia. Faculty of Medicine, University of Belgrade, dr Subotića 8, Belgrade, 11000, Serbia.Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, dr Subotića 13, Belgrade, 11000, Serbia.Faculty of Medicine, University of Belgrade, dr Subotića 8, Belgrade, 11000, Serbia. Institute for Medical Statistics and Informatics, dr Subotića 15, Belgrade, 11000, Serbia.Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, dr Subotića 13, Belgrade, 11000, Serbia.Faculty of Medicine, University of Belgrade, dr Subotića 8, Belgrade, 11000, Serbia. Institute for Pathology, dr Subotića 1, Belgrade, 11000, Serbia.Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, dr Subotića 13, Belgrade, 11000, Serbia. katarina.s.lalic@gmail.com. Faculty of Medicine, University of Belgrade, dr Subotića 8, Belgrade, 11000, Serbia. katarina.s.lalic@gmail.com.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31159858

Citation

Bogdanović, Jelena, et al. "Impact of Acute Hyperglycemia On Layer-specific Left Ventricular Strain in Asymptomatic Diabetic Patients: an Analysis Based On Two-dimensional Speckle Tracking Echocardiography." Cardiovascular Diabetology, vol. 18, no. 1, 2019, p. 68.
Bogdanović J, Ašanin M, Krljanac G, et al. Impact of acute hyperglycemia on layer-specific left ventricular strain in asymptomatic diabetic patients: an analysis based on two-dimensional speckle tracking echocardiography. Cardiovasc Diabetol. 2019;18(1):68.
Bogdanović, J., Ašanin, M., Krljanac, G., Lalić, N. M., Jotić, A., Stanković, S., Rajković, N., Stošić, L., Rasulić, I., Milin, J., Popović, D., Bogdanović, L., & Lalić, K. (2019). Impact of acute hyperglycemia on layer-specific left ventricular strain in asymptomatic diabetic patients: an analysis based on two-dimensional speckle tracking echocardiography. Cardiovascular Diabetology, 18(1), 68. https://doi.org/10.1186/s12933-019-0876-3
Bogdanović J, et al. Impact of Acute Hyperglycemia On Layer-specific Left Ventricular Strain in Asymptomatic Diabetic Patients: an Analysis Based On Two-dimensional Speckle Tracking Echocardiography. Cardiovasc Diabetol. 2019 06 3;18(1):68. PubMed PMID: 31159858.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of acute hyperglycemia on layer-specific left ventricular strain in asymptomatic diabetic patients: an analysis based on two-dimensional speckle tracking echocardiography. AU - Bogdanović,Jelena, AU - Ašanin,Milika, AU - Krljanac,Gordana, AU - Lalić,Nebojša M, AU - Jotić,Aleksandra, AU - Stanković,Sanja, AU - Rajković,Nataša, AU - Stošić,Ljubica, AU - Rasulić,Iva, AU - Milin,Jelena, AU - Popović,Dragana, AU - Bogdanović,Ljiljana, AU - Lalić,Katarina, Y1 - 2019/06/03/ PY - 2019/02/18/received PY - 2019/05/28/accepted PY - 2019/6/5/entrez PY - 2019/6/5/pubmed PY - 2020/2/25/medline KW - Acute hyperglycemia KW - Diabetes KW - Left ventricle KW - Multilayer strain KW - Two-dimensional speckle tracking SP - 68 EP - 68 JF - Cardiovascular diabetology JO - Cardiovasc Diabetol VL - 18 IS - 1 N2 - BACKGROUND: Hyperglycemia has detrimental effect on ischemic myocardium, but the impact of acute hyperglycemia on the myocardium in asymptomatic diabetic patients has not been fully elucidated. Thus, this follow-up study was aimed to investigate the effects and reversibility of acute hyperglycemia on regional contractile function of left ventricle (LV) in diabetic patients without cardiovascular disease. METHODS: The two-dimensional speckle tracking echocardiography (2D-STE), including multilayer strain analysis, was used for evaluation of global and regional LV function in asymptomatic, normotensive patients with uncomplicated diabetes, with acute hyperglycemia (≥ 11.1 mmol/l) (Group A, n = 67), or with optimal metabolic control (fasting plasma glucose < 7 mmol/l and HbA1c < 7%) (Group B, n = 20), while 20 healthy individuals served as controls (Group C). In group A, after 72 h of i.v. continuous insulin treatment (at the time euglycemia was achieved) (second examination) and after 3 months following acute hyperglycemia (third examination) 2D-STE was repeated. RESULTS: Global longitudinal strain (GLS) (- 19.6 ± 0.4%) in Group A was significantly lower in comparison to both groups B (- 21.3 ± 0.4%; p < 0.05) and C (- 21.9 ± 0.4%; p < 0.01) at baseline, while we could not detect the differences between groups B and C. Peak systolic longitudinal endocardial (Endo), mid-myocardial (Mid) and epicardial (Epi) layer strain were significantly lower in group A at baseline compared to both groups B and C. Deterioration in peak systolic circumferential strain was observed at basal LV level, in all three layers (Endo, Mid and Epi) and in mid-cavity LV level in Epi layer in group A in comparison to group C. Moreover, in group A, after euglycemia was achieved (at second and third examination) GLS, as well as peak longitudinal and circumferential strain remain the same. CONCLUSION: Acute hyperglycemia in asymptomatic diabetic patients has significant negative effects on systolic LV myocardial mechanics primarily by reducing GLS and multilayer peak systolic longitudinal and circumferential strain which was not reversible after three months of good glycemic control. SN - 1475-2840 UR - https://www.unboundmedicine.com/medline/citation/31159858/Impact_of_acute_hyperglycemia_on_layer_specific_left_ventricular_strain_in_asymptomatic_diabetic_patients:_an_analysis_based_on_two_dimensional_speckle_tracking_echocardiography_ L2 - https://cardiab.biomedcentral.com/articles/10.1186/s12933-019-0876-3 DB - PRIME DP - Unbound Medicine ER -