Assessment of left ventricular function in young type 1 diabetes mellitus patients by two-dimensional speckle tracking echocardiography: Relation to duration and control of diabetes

Abstract

Background: The effect of type 1 diabetes mellitus (T1DM) on myocardial function is still controversial. Aim: To examine the usefulness of speckle tracking echocardiography (STE) in detecting subclinical left ventricular (LV) dysfunction in asymptomatic T1DM patients and detect whether any LV abnormalities are related to duration or control of DM. Methods: Sixty young T1DM patients and 30 controls were subjected to conventional echocardiography and STE. The left ventricular (LV) peak systolic (PS) global longitudinal strain (GLS)/strain rate (GLSR) and diastolic global strain rate during the isovolumic relaxation period (GSRivr), early diastole (GSRe) and late diastole (GSRa) were calculated as the average of the 12 myocardial segments of the four and two-chamber views while the mid circumferential strain (MCS) was calculated as the average of strains of the 6 LV segments of the mid LV cavity. Results: In diabetic patients, the LV end diastolic dimension (LVEDD) was significantly lower (p = 0.000) while the LV myocardial performance index (LVMPI) and E/lateral E′ ratio were significantly higher (p = 0.000 and p = 0.02 respectively) compared to controls. By STE, only the GLS was significantly lower in diabetic patients compared to controls (p = 0.000). A significant negative correlation was detected between LDL-C and GLS (r = −0.4; p = 0.002). Multivariate logistic regression analysis identified HbA1c as the only independent predictor of GLS in patients (beta = −0.34, 95% CI: −0.67 to −0.19; p = 0.001). Conclusion: STE is useful to detect subclinical LV dysfunction in asymptomatic patients with T1DM. Control of DM but not duration of disease was an independent predictor of LV systolic dysfunction