Evaluation Of The Ventricular Longitudinal Strain And Strain Rate In Patients With Type2Diabetes Mellitus By Two-dimensional Speckle Tracking Imaging

PART one Speckle tracking imaging in evaluation of leftventricular function in type2diabetes mellitus withhypertensionObjective To investigate the systolic and diastolic function of the leftventricular in diabetes patients with high blood pressure, we study thesepatients using two-dimensional speckle tracking imaging (2D-STI), lookingforward to find the early change so as to help preventing furtherdeterioration of cardiac function.Methods A total of68cases with type2diabetes mellitus, of which37caseswith normal blood pressure and31patients combined with hypertension (DM+HTN) and39patients as control group. Apical four-chamber、two-chamberand LV long-axis view images were recorded using conventionaltwo-dimensional gray scale imaging. The peak longitudinal strain and strainrate were measured by two-dimensional speckle tracking imaging techniques,and then compared the differences between the groups.Results1. There was no significant difference between LVMI, LVEF and bodymass index (BMI) in three groups (p>0.05); The level of SBP and DBP werehigher in DM+HTN than the rest of the two groups. Although E/A ratio was lower in2-DM and DM+HTN group compared with controls, we found onlypatients in DM+HTN had significance (p <0.05);2. Compared with controlgroup the longitudinal peak strain and strain rate were lower only in DM+HTNgroup (p <0.05);3. The Characteristics of diastolic early and latediastolic longitudinal peak strain rate in three groups:The levels of earlydiastolic peak strain rate were lower in two groups compared with controlgroup, with the lowest values in DM+HTN (p<0.05); Comparing with controlgroup, two groups of patients with left ventricular diastolic latelongitudinal peak strain rate are increased, but only DM+HTN hadstatistically difference (p <0.05).Conclusion It can be concluded that the left ventricular function isimpaired in type2diabetes mellitus whether or not with hypertension. Andalso we found that left ventricular diastolic dysfunction appears earlierand left ventricular function damaged seriously in type2diabetes mellituspatients with high blood pressure. PART two Evaluation of the right ventricularlongitudinalstrain and strain rate in patients with type2diabetesmellitusby two-dimensional speckle tracking imagingObjective To found the longitudinal strain and strain rate of rightventricular in patientswith type2diabetes mellitus only and patients with hypertension and type2diabetesmellitus using two-dimensional speckle tracking imaging (2d-STI)technologyMethods A total of68cases with type2diabetes mellitus of which37caseswithnormal blood pressure and31patients combined with hypertension (DM+HTN)and39patients as control group. The thickness of left ventricular posteriorwall andinterventricular septum as wel as the diameter of the left ventricular shouldbe measuredthrough two-dimensional echocardiography. According to the left ventricularmassindex classification the patients with hypertrophy should be eliminated.Analysis of RVlongitudinal systolic strain were obtained in the apical four-chamber viewof the RV for the assessment of the RV free wall(F-PLSS), interventricular septum(S-PLSS)and theglobal RV wall (G-PLSS). The entire RV longitudinal peak systolic strain rate(G-SRs),peak early-diastolic strain rate (G-SRe) and peak late-diastolicstrain rate(G-SRa) were performed in the apical four-chamber view.Results There was no significant difference between age, sex, bodymass index (BMI), heart rate and right ventricular area rate (RVFAC) betweenthreegroups (p>0.05); The level of SBP and DBP were higher in DM+HTN than therestof the two groups(p<0.05). Although E/A ratio was lower in2-DM and D M+HTNgroup compared with controls, we found only patients in DM+HTN hadsignificance(p <0.05); There was no significant difference of LVEF in three groups.Comparedwith control group, F-PLSS, S-PLSS, G-PLSS, G-SRs and G-SRe were decreasedin2-DM and DM+HTN (all p<0.01), with lower values in DM+HTN (p<0.05). In thepatients coexisting diabetes and hypertension, G-Sra was significantly lowerthan thosein the control group (p<0.05). Compared with2-DM, this difference was notsignificantin controls and DM+HTN (p>0.05).Conclusion No matte the patients of2-DM with or without hypertension, we canfind the early changes of RV dysfunction by2D-STI. Patients coexistingdiabetes andhypertension may have worse RV dysfunction.