Clinical Research On Evaluation Of Subclinical Left Ventricular Systolic Dysfunction In Patients With Diabetes Mellitus By Two-dimensional Speckle Tracking Imaging

Objective:The conventional echocardiography and two-dimensional speckle tracking imaging (2D-STI) technique was used to assess the extent of impaired left ventricular early systolic function in diabetic patients, two kinds of inspection techniques were compared to explore the reliable evaluation index of subclinical left ventricular dysfunction in diabetic patients, and to evaluate the extent of subclinical left ventricular impairment and to provide reference for clinical treatment regimen.Methods:This study selects three groups of research objects in the Health control group(n=35), type 2 diabetes Group (n=32) and the type 2 diabetes mellitus with hypertension group (n=35),the three groups were standard routine transthoracic echocardiography,tissue doppler imaging (TDI) and 2D-STI.1. Assessment of left ventricular diastolic function:The Spectrum Doppler was used to measure the mitral orifice e peak A peak,automatically calculates the E/A value; the tissue doppler imaging was used to measure mitral annulus E’, A’, calculates the E’/A’ value, and The above data were examined by X2 test to evaluate the left ventricular diastolic function of the three groups of subjects2 .Assessment of left ventricular systolic function:The left ventricular end-diastolic volume (LVEDV),left ventricular end-systolic volume (LVESV) and the left ventricular ejection fraction(LVEF) were measured separately by conventional two-dimensional echocardiography to assess the left ventricular systolic function; At the same time, the two dimensional speckle tracing imaging technique was adopted to collect left ventricular apex four-chamber view,apical two-chamber view and apical three-chamber view of three consecutive cardiac cycle of high-frame two-dimensional dynamic, filed after off-line analysis through the GLAB software to obtain the systolic left ventricular peak longitudinal strain(Longitudinal, strain, LS) of the apical three view and the left ventricular systolic peak global longitudinal strain (GLS), to assess the left ventricular systolic function of the three groups of subjects. The data of the two different ultrasonography techniques were analyzed by a single factor ANOVA to evaluate the damage degree of the cardiac systolic function in order to explore the reliable evaluation index of subclinical left ventricular function in diabetic patients.Results:1. Compared with healthy control group, type 2 diabetes mellitus group,hypertension type 2 diabetes mellitus group and the healthy control group, the E/A and E’/A’groups in the study group were statistically significant (p <0.05), suggesting that type 2 diabetes mellitus (T2DM), and/or hypertension can cause left ventricular diastolic function decreased;2. There was no statistically significant difference in the LVEDV, LVESV and LVEF between the health control group, type 2 diabetes mellitus group and type 2 diabetes mellitus with hypertension group (p>0.05), and the conventional ultrasound was described as a group of type 2 diabetes mellitus, type 2 diabetic mellitus with hypertension group, compared with the normal control group, the systolic function did not change;3.The left ventricular hypertrophy and the left ventricular strain were measured in the systolic left ventricle of the apical four-chamber, apical three-chamber and apical two-chamber view in the healthy control group, type 2 diabetes mellitus group, type 2 diabetes mellitus with hypertension group. There was a statistically significant difference between the two groups (p <0.05). Suggesting that the two-dimensional speckle tracing technique found that type 2 diabetes mellitus, type 2 diabetes mellitus with hypertension group compared with the normal control group the systolic function of a certain degree of change, At the same time, diabetic patients with hypertension have a superimposed effect on subclinical ventricular systolic dysfunction;Conclusions:1. This study showed that most subclinical left ventricular diastolic diarrhea in diabetic patients already exist obstacles;2.Using conventional echocardiography to measure LVEF to assess left ventricular systolic function is not easy to detect the early presence of left ventricular subclinical systolic dysfunction, that the two-dimensional spot tracking technique compared with conventional ultrasound can be found earlier subclinical systolic dysfunction in clinical work In the application of higher value, is a reliable method for clinical evaluation of diabetic subclinical left ventricular systolic function;3. Diabetic patients with hypertension have a superimposed effect on subclinical ventricular systolic dysfunction;4. In patients with diabetes mellitus, the reduction of subclinical systolic function can occur simultaneously with diastolic dysfunction, or may even precede diastolic dysfunction.