Evaluation Of Left Ventricular Systolic Function In Patients With Type2Diabetes By Three-dimensional Speckle Tracking Imaging

ObjectiveApplication of three-dimensional speckle tracking imaging (3D-STI)technology to detect early in patients with type2diabetes does not appear leftventricular configuration changes, the left ventricular systolic function isdamaged. Thereby providing a more objective, more sensitive detectionmethods for the clinical diagnosis of diabetic cardiomyopathy.MethodsUsing the American GE vivid E9color doppler ultrasonic diagnosticinstrument, forty of patients with type2diabetes and forty healthy volunteerswere included.3D-STI were recorded from left ventricular apical four-chamberviews to measure values of left ventricular end-diastolic volume (LVEDV), leftventricular end systolic volume (LVESV), left ventricular ejection fraction (LVEF),and the left ventricular segmental strain parameters: longitudinal strain,radialstrain, and circumferential strain,area strain (LS, RS and CS, AS). The valueswere compared between the two groups, and the correlations between leftventricular each global strain values and left ventricular ejection fraction wereanalyzed respectively. Results1. Comparison of parameters from two-dimensionalechocardiographyThe A peak mitral flow and E/A were lower in diabetes groups than innormal controls (P＜0.05); Two groups of E peak, LVDd and LVDs, IVSd,LVPWd, LVEDV, LVESV, LVEF has no statistically significant difference(P＞0.05).2. Comparisons of parameters from three-dimensional speckletracking imaging(1) longitudinal strain: The left ventricular segmental myocardial longitudinalstrain values were lower in diabetes groups than in normal controls（P＜0.05),especially BA,BI,BS, MA, MI, MS,MAS and AA,AL,AI,AS decreased significantly（P＜0.01).(2) Radial strain: The left ventricular segmental myocardial radial strainvalues were lower in diabetes groups than in normal controls. In addition to BA,BP and MAS, the rest of the segmental differences were statistically significant(P＜0.05), especially ML, MS and AI decreased significantly（P＜0.01).(3) Circumferential strain: The left ventricular segmental myocardialcircumferential strain values were lower in diabetes groups than in normalcontrols. In addition to BA,BL,BP, MA,MP and AA, the rest of the segmentaldifferences were statistically significant (P＜0.05).（4）Area strain：The left ventricular segmental myocardial area strainvalues were lower in diabetes groups than in normal controls. In addition to BL,BP, the rest of the segmental differences were statistically significant (P＜0.05),especially MAS, AA and AS decreased significantly.(5) The LVEDV,LVESV were higher in diabetes groups than in normalcontrols, and the LVEF were lower in diabetes groups than in normal controls (P＜0.05);The LVGLS, LVGRS,LVGCS and LVGAS were lower in diabetesgroups than in normal controls, especially the LVGLS decreased significantly(P＜0.01).3Correlation analysisControl group LVGLS, LVGRS, LVGCS and LVGAS associated with LVEF(r1=-0.88, P1＜0.001; r2=0.001, P2=0.012; r3=-0.64, P3＜0.001; r4=-0.76,P4＜0.001); Diabetes group LVGLS, LVGRS, LVGCS and LVGAS associatedwith LVEF (r1=-0.84, P1＜0.001; r2=0.48, P2＜0.001; r3=-0.61, P3＜0.001;r4=-0.73, P4＜0.001).Conclusions1. Patients with early diabetes mellitus can appear left ventricular regionalsystolic dysfunction.2. Patients with early diabetes mellitus may be apper left ventricular systolicdysfunctiom, with global left ventricular longitudinal strain decreased mostsignificantly.3.3D-STI can be used as a new method for noninvasive clinical evaluationof left ventricular function in early diabetes.