Left ventricular strain imaging in asymptomatic patients with type 2 diabetes mellitus with or without hypertension

Background: Subclinical changes in LV function can be identified by quantifying myocardial strain. Early detection of diabetic heart disease is important for the timely interventions resulting in the prevention for the future development of heart failure.The aim of this study was to assess the ability of subtle differences in LV principal strains to characterize features of subclinical LV systolic dysfunction in patients with diabetes mellitus with or without systemic hypertension and apparently preserved LV systolic function. Methods and results: 2-dimensional echocardiographic (2DE) images of the LV were acquired in apical 4-chamber and parasternal short-axis at the basal, mid, and apical levels in 150 subjects, including 60 healthy controls (52.62 yrs. ± 6.51) and 90 patients with diabetes mellitus (53.63yrs. ± 6.27) patients out of which 45 patients were hypertensive also. Using 2D strain software, end-systolic longitudinal strain (LS), radial strain (RS), and circumferential strain (CS) were measured in 18 LV segments. No significant differences in LVEF were noted between groups. In comparison with normal controls, peak LS, peak CS was markedly attenuated in the patients with diabetes mellitus patients with or without systemic hypertension. However, radial strain was not significantly different in the two groups. Conclusion: In conclusion, the LV longitudinal and circumferential systolic and diastolic function were impaired,but the radial functions were preserved in patients with uncomplicated type 2 diabetes mellitus with or without systemic hypertension.