Evaluation Of Early Left Ventricular Systolic Function In Patients With Type 2 Diabetes Mellitus By Three-dimensional Speckle Tracking Imaging

[Objective]Three-dimensional speckle tracking imaging(3D-STI) was used to evaluate global and regional left ventricular systolic function in patients with type 2 diabetes mellitus(T2DM),and to explore the correlation between global strain and carotid intima-media thickness(CIMT),so as to provide imaging basis for early detection and early treatment of myocardial function damage in patients with T2 DM.[Methods]60 patients with T2DM(DM group) and 60 healthy volunteers matched with sex and age(control group)were collected.Routine two-dimensional echocardiography and carotid echocardiography were performed to measure and compare the left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD) and maximum carotid intimamedia thickness(max-CIMT).Then the three-dimensional full volume images of the left ventricle were collected by 3D-STI.After analyzing the images,the system automatically obtained the strain parameters of each segment: longitudinal,circumferential,radial and area strain(LS,CS,RS and AS),and the global strain parameters: global longitudinal,circumferential,radial and area strain(GLS,GCS,GRS and GAS).Pearson correlation analysis was used to compare the correlation between global strain and max-CIMT in patients with diabetes.[Results]1.Comparison of general clinical data and routine ultrasound parameters between the two groupsCompared with the control group,BMI,fasting blood glucose,Hb A1 c,IVST,RWT and max-CIMT increased in DM group,while the ratio of E/A and e/a decreased,and the difference was statistically significant(P < 0.05),but there was no significant difference in age,sex,heart rate,systolic blood pressure,diastolic blood pressure,LVEDD,LVESD,LAD and 2D-LVEF between the two groups(P > 0.05).2.Comparison of three-dimensional global strain parameters between two groupsCompared with the control group,GLS,GRS,GCS and GAS decreased significantly in DM group(P < 0.05),but there was no significant difference in 3D-LVEF between the two groups(P > 0.05).3.Comparison of segmental strain parameters of left ventricle between two groups(1)Longitudinal strain: compared with the control group,the longitudinal strain in all segments of the DM group was decreased,with statistically significant differences in all segments except BL(P < 0.05).Among them,BA,BS,BP,AA,AS,AL and A decreased most significantly(P < 0.001).(2)Circumferential strain: compared with the control group,the circumferential strain in all segments of the DM group was decreased,with statistically significant differences in all segments except BL and MA(P < 0.05).Among them,BI,MAS and MP decreased most significantly(P < 0.001).(3)Radial strain: compared with the control group,the radial strain in all segments of the DM group was decreased,with statistically significant differences in all segments except BA,BAS,ML and A(P < 0.05).Among them,BS,BL,MA,MI,MP and AI decreased most significantly(P < 0.001).(4)Area strain: compared with the control group,the area strain of all segments in the DM group was decreased,with statistically significant differences in all segments except BL(P < 0.05).Among them,BP,MS,ML,AS and A decreased most significantly(P < 0.001).4.Correlation analysis showed that the diabetic group |GLS|,|GCS|,|GRS|,|GAS| had a negative correlation with max-CIMT,and the correlation of |GLS| was the most significant(r =-0.544,P < 0.001).[Conclusions]1.3D-STI can early detect subclinical systolic dysfunction of left ventricular myocardium in diabetic patients,which is manifested by the reduction of global and regional myocardial systolic function in multiple directions(longitudinal,circumferential,radial and area).2.There was a negative correlation between left ventricular GLS,GCS,GRS and GAS and max-CIMT in diabetic patients,and the correlation of GLS was the highest.