| Part ? Assessment of left ventricular global diastolic function Objective:To evaluate left ventricular diastolic function in patients with type 2 diabetes mellitus(T2DM)using mitral annulus displacement automatic tracking(MAD)and real-time three-dimensional echocardiography(RT-3DE).Methods:54 patients with T2DM were divided into two groups according to the course of disease:DM group 1(n=26)with a course less than or equal to 5 years,DM group2(n=28)with a course more than 5 years;27 healthy volunteers were selected as the control group.MAD was used to measure early diastolic(De)and late diastolic(Da)shifts at the posterior septum,lateral wall,anterior wall,inferior wall of the mitral valve annulus,and early mean displacement(EDefour-chember,EDetwo-chamber),late diastolic mean displacement(EDafour<chamber,EDAtwo-chamber),double-plane of left ventricular diastolic's early mean displacement(EDedouble-plane),late diastolic mean displacement(EDadouble-phane).Left ventricular ejection fraction(LVEF),end-diastolic volume(EDV),end-systolic volume(ESV),stroke volume(SV),and left ventricular peak filling rate(PFR)were calculated by using RT-3DE.Compare the differences between all groups.Results:There were significant differences between De and EDefour-chamber,EDetwo-chamber,and EDedouble-plane between the four sites of posterior septum,lateral wall,anterior wall,and inferior wall of mitral annulus(P<0.05).There were no significant differences in Da and EDafour-chamber,EDatwo-chamber,and EDadouble-plane in the four sites of the mitral valve annulus(P>0.05).There was a statistically significant difference in PFR between groups(P<0.05).There was no significant difference in LVEF,EDV,ESV,and SV between groups(P>0.05).There was a positive correlation between EDedouble-plane and PFR(r=0.608,P=0.000),but there was no significant correlation between EDadouble-plane and PFR(r=-0.130,P=0.348).Conclusion:Left ventricular diastolic dysfunction in patients with T2DM is earlier than systolic dysfunction.MAD and RT-3DE have a good correlation in evaluating left ventricular global and local diastolic function in T2DM patients.Part ?:Assessment of left ventricular segmental diastolic function Objective:To obtain the volume parameters of left ventricular(LV)diastolic 17 segments in type 2 diabetes patients by real-time three-dimensional echocardiography(RT-3DE),and to evaluate left ventricular diastolic function from a overall and local perspective.Methods:This Study included 59 type 2 diabetes patients(29 patients with disease duration less than or equal to 5 years in DMI group,30 patients with disease duration more than 5 years in DM2 group)and 30 normal controls.The volume-time curve(VTE)of the 17 segments of the LV was obtained by RT-3DE technique,and the peak filling rate(rPFR)of each segment was calculated.Take the rPFR average value of the 6 basal segment as E basal segment,the rPFR average value of the 6 segments in the middle section as E intermediate segment,the rPFR average value of the 4 segments of the apex segment as E apex,and then compare the parameters between the groups.Results:In the comparison of E basal segment,E intermediate segment and E apex in the three groups,the difference between DM2 group and other two groups was statistically significant(P<0.05).There was no significant difference between DM1 group and control group(P>0.05).Four of the five rPFR values in the anterior and posterior intervals of the three groups were statistically significant(P<0.01).In the 8 rPFR values in the anterior wall,lateral wall,and posterior wall of the LV,6 in DM2 group had significant difference compared other two groups(P<0.05),but there was no significant difference in the four rPFR values of the inferior wall and the apex(P>0.05).Conclusion:The LV volume parameter PFR obtained by RT-3DE technique can be used as a sensitive index for assessing overall and local diastolic function impairment. |
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