Vector flow mapping analysis of left ventricular vortex performance in type 2 diabetic patients with early chronic kidney disease

BACKGROUND: Diabetes is the leading cause of chronic kidney disease (CKD) and contributes to an elevated incidence of diastolic dysfunction in the early stages of CKD. Intracardiac vortex is a novel hemodynamic index for perceiving cardiac status. Here, we visualized left ventricular (LV) vortex characteristics using vector flow mapping (VFM) in type 2 diabetic patients with early CKD. METHODS: This cross-sectional study included 67 controls and 89 type 2 diabetic patients with stages 2-3a CKD. All subjects underwent transthoracic echocardiographic examination. LV anterior vortex during early diastole (E-vortex), atrial contraction (A-vortex) and systole (S-vortex) were assessed using VFM in the apical long-axis view. Its relation to glycemia or LV filling echocardiographic parameters were further analyzed using correlation analysis. RESULTS: Type 2 diabetic patients with early CKD had a small area (439.94 ± 132.37 mm(2) vs. 381.66 ± 136.85 mm(2), P = 0.008) and weak circulation (0.0226 ± 0.0079 m(2)/s vs. 0.0195 ± 0.0070 m(2)/s, P = 0.013) of E-vortex, but a large area (281.52 ± 137.27 mm(2) vs. 514.83 ± 160.33 mm(2), P ˂ 0.001) and intense circulation (0.0149 ± 0.0069 m(2)/s vs. 0.0250 ± 0.0067 m(2)/s, P < 0.001) of A-vortex compared to controls. CKD patients with poorly controlled hyperglycemia had stronger A-vortex (area: 479.06 ± 146.78 mm(2) vs. 559.96 ± 159.27 mm(2), P = 0.015; circulation: 0.0221 ± 0.0058 m(2)/s vs. 0.0275 ± 0.0064 m(2)/s, P < 0.001) and S-vortex (area: 524.21 ± 165.52 mm(2) vs. 607.87 ± 185.33 mm(2), P = 0.029; circulation: 0.0174 ± 0.0072 m(2)/s vs. 0.0213 ± 0.0074 m(2)/s, P = 0.015), and a longer relative duration of S-vortex (0.7436 ± 0.0772 vs. 0.7845 ± 0.0752, P = 0.013) than those who had well-controlled hyperglycemia. Glycemia, and E/A (a LV filling parameter) were respectively found to had close correlation to the features of A-vortex and S-vortex (all P < 0.05). CONCLUSIONS: Abnormal LV vortices were detected in type 2 diabetic patients with early CKD using VFM, especially in those who neglected hyperglycemic control. LV vortex might be a promising parameter to slow or halt the hyperglycemia-induced diastolic dysfunction in early CKD. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12872-023-03474-7.