Changes Of Left Ventricular Structure And Function In Patients With Newly Diagnosed Type2Diabetes

Objective To investigate whether the Left ventricular structure and function changed in the patients with newly diagnosed type2diabetes.Method58patient with newly diagnosed type2diabetes were divided into T2DM group (26normotensive) and T2DM+HT group (32hypertensive), they all underwent Transthoracic echocardiography and tissue Doppler Imagine Analysis by use of the methods recommended by American Society of Echocardiography and European Association of Echocardiography in2005and2009,and their HBAlc, fasting blood glucose (FPG),plasma N-terminal B-type brain natriuretic peptide(NT-proBNP), blood urea nitrogen and other relevant laboratory indexes were tested. Datas were compared with32age-and-sex-matched healthy people.Results Left ventricular mass index (LVMi) were increased in both T2DM and T2DM+HT groups compared with control group.(P<0.01or P<0.05).Left atrial dimension(LAD) and LAD index(LADi), Left atrial volume(LAV)and LAV index (LAVi) were no statistically significant.Relative wall thickness(RWT) showed increment only in T2DM+HT group. Interventricular septal thickness (IVSTd,IVSTs) posterior wall thickness(PWTd PWTs) were increased in T2DM+HT group compared with control and T2DM group. LVMi was correlated positively with body mass index、waist circumference、hip circumference, Systolic blood pressure、 diastolic blood pressure、E/E’S and M-E/E’. But the result of analysis of covariance showed the difference disappeared among three groups by controlling body mass index and systolic pressure.E/A ratio (E:Peak early diastolic mitral inflow velocity A:Peak late diastolic mitral inflow velocity), deceleration time(DT) of E wave, Isovolumic relaxation time(IVRT), and all the parameters from pulmonary venous flow were no statistically significant difference among the three groups. The left ventricular flow propagation velocity(FPV) and E/FPV in T2DM were no significantly different with the control group, while the E/FPV ratio in T2DM+HT group were higher than the control and T2DM group. E/E’L ratio of T2DM+HT group was significantly different from the control and T2DM group.E/E’L, E/E’S and M-E/E’ were all increased from control group to T2DM group and to T2DM+HT group in order (F=3.619,5.071,4.634, P=0.031,0.008,0.012). E/E’S was correlated positively with body mass index, waist circumference, Systolic blood pressure, LAVi and LVMi, But negatively with height. The result of multiple linear regression analysis showed that LAVi、BMI and waist circumference had an independent effect on with E/E’S. M-E/E’ were positively correlated with age, BMI, waist hip circumference, Systolic blood pressure, LogNT-ProBNP, left atrial volume index(LADi)and left ventricular mass index(LVMi),but negatively with height. But those trend disappeared by controlling body mass index and systolic pressure with covariance analysis.Conclusion:Left ventricular ejection fraction in the three groups were all in the normal range. Left ventricular structural and functional alterations, with increased LVMi and impaired diastolic function as the major ones, presented in the newly diagnosed type2diabetic patients and exacerbated in those with hypertension, which might resulted from elevated body weight and higher blood pressure in the diabetic patients. And the E/E’S ratio, M-E/E’ ratio were more sensitive and specificitive than E/A, DT, IVRT, and FPV.