Investigation of the Possible Risk Factors Associated with Subclinical Left Ventricular Dysfunction Assessed by 2D Speckle Tracking Echocardiography in Patients with Type 2 Diabetes Mellitus and Normal Ejection Fraction

authors:

avatar Mehdi Pishgahi ORCID 1 , avatar Fariba Bayat 2 , avatar Rama Bozorgmehr ORCID 3 , avatar Shirin Ghane Fard 3 , avatar Hamid Rafiei Sadr 3 , avatar Seyedeh Maryam Motahari 3 , avatar Kimia Karimi Toudeshki ORCID 1 , *

Cardiology Department, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
Internal Medicine Department, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
International Cardiovascular Research Journal: Vol.17, issue 2; e138792
published online: June 30, 2023
article type: Research Article
revised: May 26, 2023

how to cite: Pishgahi M, Bayat F, Bozorgmehr R, Ghane Fard S, Rafiei Sadr H, et al. Investigation of the Possible Risk Factors Associated with Subclinical Left Ventricular Dysfunction Assessed by 2D Speckle Tracking Echocardiography in Patients with Type 2 Diabetes Mellitus and Normal Ejection Fraction. Int Cardiovasc Res J. 2023;17(2):e138792. 

Abstract

Background: Subclinical left ventricular dysfunction is an important predictor of cardiovascular death, detected via the global longitudinal strain (GLS) echocardiographic parameter. While T2DM is associated with a worse GLS, it is not cost-effective to perform 2D speckle tracking echocardiography for all asymptomatic T2DM patients to screen for early signs of subclinical left ventricular dysfunction.
Objectives: We aimed to investigate the association of possible risk factors with subclinical left ventricular dysfunction assessed by 2D speckle tracking echocardiography in T2DM patients with normal ejection fraction, excluding patients with comorbidities associated with left ventricular dysfunction such as hypertension or any cardiovascular disease.
Methods: This cross-sectional study involved patients aged >18 with type 2 diabetes mellitus (T2DM) and EF ≥ 50% referred to Shohada-e-Tajrish Hospital, Tehran, Iran, from May 2, 2023, to June 21, 2023. Patients with any history or signs and symptoms of heart disease and hypertension were excluded. The correlation of GLS with age, BMI, duration of diabetes, systolic (SBP) and diastolic blood pressure (DBP), and laboratory parameters was assessed using Pearson's correlation test, with P < 0.05 denoting significance.
Results: In this cross-sectional study, 118 patients consisting of 70 women (59.32%) and 48 men (40.68%) with T2DM were enrolled. The mean age of the participants was 49.61 ± 5.10 years. The mean GLS was -16.71 ± 2.14%. The GLS correlated positively with BMI (P = 0.038 and r = 0.197), SBP (P = 0.003 and r = 0.268), DBP (P = 0.023 and r = 0.209), homocysteine (P = 0.001 and r = 0.310), HbA1C (P = 0.046 and r = 0.184), LDL (P = 0.034 and r = 0.203), and TG (P < 0.001 and r = 0.375), and negatively with GFR (P < 0.001 and r = -0.363).
 
Conclusions: BMI, SBP, DBP, homocysteine, HbA1C, LDL, TG, and GFR correlated with subclinical left ventricular dysfunction assessed by GLS in patients with T2DM; these markers may offer value in selecting T2DM patients for cost-effective 2D speckle tracking echocardiography screening of subclinical left ventricular dysfunction.

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