Assessment Of Left Ventricular Diastolic Function In Patients With Type 2 Diabetes Mellitus

Objective: To evaluate early left ventricular diastolic function in the patients with type 2 diabetes mellitus using more parameters of echocardiogram. We analyze the relation between LAVI and E/Em, between FPV and E/Em to provide a reliable diagnostic foundation for early prevention and early treatment to type 2 diabetes mellitus.Method: Thirty type 2 diabetic patients who were diagnosed by diagnostic and classification standard of WHO 1999 for diabete were enrolled. Male 17 cases,Female 13 cases, year old from 36 to 79,average age(52.33±11.71),Selection standard :All patients who were thirty years old or older were diagnosed by clinic 、 electrocardiogram 、 dynamic electrocardiogram and conventional ultrasound beckoning diagram. Patients with rheumatic heart disease,heart valve diseases,pericardial disease,congenital heart disease, chronic obstructive pulmonary disease,other chronic and metabolic diseases were ruled out. Patients with family history of hypertension, coronary heart disease, myocardosis and other metabolic disease were ruled out. The poor image quality and unsinus rhythm were ruled out. All selected candidate were sinus rhythm. Thirty healthy subjects who were thirty years old or older were collected in control group. Male 14 cases,Female 16 cases, year old from 38 to 69,average age(54.40±7.7),They were routine examinated as the case group. Exclusion criteria was as same as the case group. The two groups have no significant differences in age、sex、height、heart rate、weight.We routinely measure and calculate chocardiography measurements of the indicators: left atrial volume(LAV), left ventricular end diastolic volume(LVEDV), left ventricular ejection fraction(LVEF), left ventricular fractional shortening(LVFS),the body surface area and left atrial volume index(LAVI), early mitral inflow velocity E and end mitral inflow velocity A,left ventricular isovolumetric relaxation(IVRT), early mitral inflow velocity E decelerate time(DT) and E/A ratio,We measured two positions of the mitral annulus by tissue Doppler imaging for early mitral annulus diastolic velocity Em,end mitral annulus diastolic velocity Am, Em/ Am ratio, and E/Em ratio,left ventricular early diastolic flow propagation velocity(FPV).We contrast and analyze the indicators of the two groups and the relation between LAVI and FPV, the relation between LAVI and E/Em.Statistics methods: Analysis was done by SPSS19.0 statistical software. Measurement data was showed by means ±standard deviation. First we do normality test and homogeneity test of variance. The two groups conforming to normal distribution and homogeneity of variance using T test. Correlation of two variables was analysed by Spearman association analysis. P<0.05,there was statistical significance.Results:1 There was no significant differences between case group and control group in age、sex、height、heart rate、weight(P>0.05). There was no significant differences in LVEDd、LVEF、LVFS between the two groups(P>0.05).2 In the diabetic patients, there was a significant decreased in E、Em、E/A and Em/Am ratios,significant increased in Am and LAVI and significant prolonged in DT and IVRT. The differences have statistical significance(P<0.05).3 The detection rate of decrease of left ventricular diastolic function in the diabetic group was 80% by DTI and 40% by PWD. There was a statistical significance in the two inspection methodes(P<0.05).4 There is a good correlation between LAVI and E/Em(r=0.879,P<0.05). LAVI can be estimated left ventricular filling pressure as E/Em, and further reflect the left ventricular diastolic function. There is a negative correlation between FPV and E/Em(r=-0.642,P<0.01). FPV can reliably reflect the left ventricular relaxation. When E/Em which can be estimated left ventricular filling pressure goes up, FPV which can be estimated left ventricular relaxation reduces. It is explain that FPV is a good indicator on estimating the left ventricular diastolic function.Conclusion:1 In assessment of the left diastolic function, PWD and TDI show a good correlation. But the later shows better performance sensitively and accurately than the first. The detection rate of decrease of left ventricular diastolic function in the diabetic group was 80% by DTI and 40% by PWD. There was a statistical significance in the two inspection methods(P<0.05).2 In the left ventricular diastolic function evaluation,E/Em、TDI and FPV can provide early evidence for of diabetic cardiomyopathy of due to its potent ability in differentiation of false-normal presentations.3 LAVI and E/Em has a a good correlation,FPV and E/Em has a a negative correlation.Many parameters unite to evaluate the left ventricular diastolic function more sensitively and accurately in patients with type 2 diabetes mellitus.