Version 1
: Received: 26 July 2024 / Approved: 29 July 2024 / Online: 30 July 2024 (07:04:33 CEST)
How to cite:
Akasheva, D. U.; Utina, T. G.; Dzhioeva, O. N.; Drapkina, O. M. Subclinical Left Ventricular Dysfunction over Seven-year Follow-up in Type 2 Diabetes Patients without Cardiovascular Diseases. Preprints2024, 2024072329. https://doi.org/10.20944/preprints202407.2329.v1
Akasheva, D. U.; Utina, T. G.; Dzhioeva, O. N.; Drapkina, O. M. Subclinical Left Ventricular Dysfunction over Seven-year Follow-up in Type 2 Diabetes Patients without Cardiovascular Diseases. Preprints 2024, 2024072329. https://doi.org/10.20944/preprints202407.2329.v1
Akasheva, D. U.; Utina, T. G.; Dzhioeva, O. N.; Drapkina, O. M. Subclinical Left Ventricular Dysfunction over Seven-year Follow-up in Type 2 Diabetes Patients without Cardiovascular Diseases. Preprints2024, 2024072329. https://doi.org/10.20944/preprints202407.2329.v1
APA Style
Akasheva, D. U., Utina, T. G., Dzhioeva, O. N., & Drapkina, O. M. (2024). Subclinical Left Ventricular Dysfunction over Seven-year Follow-up in Type 2 Diabetes Patients without Cardiovascular Diseases. Preprints. https://doi.org/10.20944/preprints202407.2329.v1
Chicago/Turabian Style
Akasheva, D. U., Olga Nikolaevna Dzhioeva and Oxana Mikhailovna Drapkina. 2024 "Subclinical Left Ventricular Dysfunction over Seven-year Follow-up in Type 2 Diabetes Patients without Cardiovascular Diseases" Preprints. https://doi.org/10.20944/preprints202407.2329.v1
Abstract
Objective: Subclinical left ventricular disfunction (LVD) is common in asymptomatic patients with type 2 diabetes (T2D). Many patients with diabetes have an impaired diastolic and systolic function. With preserved ejection fraction LV (EFLV), the latter is defined as reduced global longitudinal strain (GLS), detected using the speckle-tracking echocardiography. This study is aimed to define the long-term structural and functional disorders of the LV myocardium in patients with T2D without CVD. Methods: Of the 120 patients with and without T2D of both sexes aged from 45 to 75 years (57.11±7.9 years), included in the study in 2012-2013, only 57 responded to the follow-up study. The patients were divided into two groups: one with T2D (n=29), the other without it, control (n=28). All patients underwent transthoracic two-dimensional echocardiography with assessment of standard indicators of systolic and diastolic cardiac function, as well as GLS. In addition, all participants underwent laboratory diagnostics of carbohydrate metabolism disorders markers, NT-proBNP and CRP. The median follow-up duration was 7.2 [7.0-7.8] years. Results: During the follow-up, a statistically significant increase in the incidence of diastolic dysfunction (DD) in the type 2 diabetes group was found from 53% to 61% (p = 0.004); no significant dynamics were noted in the control group (p = 0.48). The presence of T2D significantly increases the risk of developing DD (p=0.04). The presence of T2D, increased fasting glucose levels, and an increased HOMA index were independent predictors of the development of DD. Impairment of LVEF was not observed in both groups. At the same time, the proportion of patients with reduced GLS (< -18%) increased in the T2D group (p = 0.036). A significant difference in the frequency of decreased GLS depending on T2D was demonstrated. The presence of obesity, an increase in the HOMA index and an increase in CRP levels are independent predictors of impaired GLS. Conclusions: T2D is an independent risk factor for the worsening of subclinical left ventricular dysfunction in asymptomatic patients with T2D without CVD over 7-year follow-up. Diastolic dysfunction is represented by delayed relaxation of the LV myocardium; with preserved LVEF, reduced 2D GLS identifies systolic dysfunction. The tight control of glycemia, lipidemia, blood pressure and body weight is associated with the absence of poor clinical outcomes.
Keywords
type 2 diabetes; subclinical left ventricular dysfunction; diastolic disfunction; global longitudinal strain
Subject
Medicine and Pharmacology, Cardiac and Cardiovascular Systems
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
