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Impaired left ventricular diastolic function in T2DM patients is closely related to glycemic control

BACKGROUND: Left ventricular (LV) diastolic dysfunction commonly is observed in individuals with type 2 diabetes mellitus (T2DM). We employed transthoracic echocardiography (TTE) and cardiac magnetic resonance imaging (CMRI) to investigate the hypothesis that LV diastolic dysfunction in T2DM is asso...

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Autores principales: Clarke, Geoffrey D., Molina‐Wilkins, Marjorie, Solis‐Herrera, Carolina, Mendez, Verna, Monroy, Adriana, Cersosimo, Eugenio, Chilton, Robert J., Abdul‐Ghani, Muhammad, DeFronzo, Ralph A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6354805/
https://www.ncbi.nlm.nih.gov/pubmed/30815550
http://dx.doi.org/10.1002/edm2.14
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author Clarke, Geoffrey D.
Molina‐Wilkins, Marjorie
Solis‐Herrera, Carolina
Mendez, Verna
Monroy, Adriana
Cersosimo, Eugenio
Chilton, Robert J.
Abdul‐Ghani, Muhammad
DeFronzo, Ralph A.
author_facet Clarke, Geoffrey D.
Molina‐Wilkins, Marjorie
Solis‐Herrera, Carolina
Mendez, Verna
Monroy, Adriana
Cersosimo, Eugenio
Chilton, Robert J.
Abdul‐Ghani, Muhammad
DeFronzo, Ralph A.
author_sort Clarke, Geoffrey D.
collection PubMed
description BACKGROUND: Left ventricular (LV) diastolic dysfunction commonly is observed in individuals with type 2 diabetes mellitus (T2DM). We employed transthoracic echocardiography (TTE) and cardiac magnetic resonance imaging (CMRI) to investigate the hypothesis that LV diastolic dysfunction in T2DM is associated with poor glycemic control. METHODS: Forty subjects, 21 with normal glucose tolerance (NGT) and 19 with T2DM, were studied with CMRI and TTE to assess LV function. Early‐to‐late transmitral flow ratio (E/A) and deceleration time (DecT) were assessed with both modalities. Normalized (to body surface area) end‐diastolic volume (EDV/BSA) and normalized peak LV filling rate (pLVFR/BSA) were assessed with CMRI. Early transmitral flow velocity to septal velocity (E/e’) and isovolumetric relaxation time (IVRT) were measured using TTE. Dimensional parameters were normalized to body surface area (BSA). RESULTS: CMRI measurements demonstrated impaired E/A (1.13 ± 0.34 vs 1.62 ± 0.42, P < .001), increased DecT (174 ± 46 ms vs 146 ± 15, P = .005), as well as lower EDV/BSA (63 ± 10 vs 72 ± 9 mL/m(2), P < .01) and pLVFR/BSA (189 ± 46 vs 221 ± 48 mL s(−1) m(−2), P < .05) in T2DM subjects. TTE measurements revealed lower E/A (1.1 ± 0.4 vs 1.4 ± 0.2, P < .001) and E/e’ (6.8 ± 1.5 vs 8.7 ± 2.0, P < .0001) with higher DecT (203 ± 22 ms vs 179 ± 18, P < .001) and IVRT (106 ± 14 ms vs 92 ± 10, P < .001) in T2DM. Multiple parameters of LV function: E/A(CMRI) (r = −.50, P = .001), E/A(TTE) (r = −.46, P < .005), pLVFR/BSA (r = −.35, P < .05), E/e’ (r = −.46, P < .005), EDV/BSA(CMRI) (r = −.51, P < .0001), EDV/BSA(TTE) (r = −.42, P < .01) were negatively correlated with HbA1c. All but E/e’ also were inversely correlated with fasting plasma glucose (FPG). CONCLUSIONS: Impaired LV diastolic function (DF) was found in T2DM subjects with both CMRI and TTE, and multiple LVDF parameters correlated negatively with HbA1c and FPG. These results indicate that impaired LVDF is inversely linked to glycemic control in T2DM patients.
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spelling pubmed-63548052019-02-27 Impaired left ventricular diastolic function in T2DM patients is closely related to glycemic control Clarke, Geoffrey D. Molina‐Wilkins, Marjorie Solis‐Herrera, Carolina Mendez, Verna Monroy, Adriana Cersosimo, Eugenio Chilton, Robert J. Abdul‐Ghani, Muhammad DeFronzo, Ralph A. Endocrinol Diabetes Metab Original Articles BACKGROUND: Left ventricular (LV) diastolic dysfunction commonly is observed in individuals with type 2 diabetes mellitus (T2DM). We employed transthoracic echocardiography (TTE) and cardiac magnetic resonance imaging (CMRI) to investigate the hypothesis that LV diastolic dysfunction in T2DM is associated with poor glycemic control. METHODS: Forty subjects, 21 with normal glucose tolerance (NGT) and 19 with T2DM, were studied with CMRI and TTE to assess LV function. Early‐to‐late transmitral flow ratio (E/A) and deceleration time (DecT) were assessed with both modalities. Normalized (to body surface area) end‐diastolic volume (EDV/BSA) and normalized peak LV filling rate (pLVFR/BSA) were assessed with CMRI. Early transmitral flow velocity to septal velocity (E/e’) and isovolumetric relaxation time (IVRT) were measured using TTE. Dimensional parameters were normalized to body surface area (BSA). RESULTS: CMRI measurements demonstrated impaired E/A (1.13 ± 0.34 vs 1.62 ± 0.42, P < .001), increased DecT (174 ± 46 ms vs 146 ± 15, P = .005), as well as lower EDV/BSA (63 ± 10 vs 72 ± 9 mL/m(2), P < .01) and pLVFR/BSA (189 ± 46 vs 221 ± 48 mL s(−1) m(−2), P < .05) in T2DM subjects. TTE measurements revealed lower E/A (1.1 ± 0.4 vs 1.4 ± 0.2, P < .001) and E/e’ (6.8 ± 1.5 vs 8.7 ± 2.0, P < .0001) with higher DecT (203 ± 22 ms vs 179 ± 18, P < .001) and IVRT (106 ± 14 ms vs 92 ± 10, P < .001) in T2DM. Multiple parameters of LV function: E/A(CMRI) (r = −.50, P = .001), E/A(TTE) (r = −.46, P < .005), pLVFR/BSA (r = −.35, P < .05), E/e’ (r = −.46, P < .005), EDV/BSA(CMRI) (r = −.51, P < .0001), EDV/BSA(TTE) (r = −.42, P < .01) were negatively correlated with HbA1c. All but E/e’ also were inversely correlated with fasting plasma glucose (FPG). CONCLUSIONS: Impaired LV diastolic function (DF) was found in T2DM subjects with both CMRI and TTE, and multiple LVDF parameters correlated negatively with HbA1c and FPG. These results indicate that impaired LVDF is inversely linked to glycemic control in T2DM patients. John Wiley and Sons Inc. 2018-04-06 /pmc/articles/PMC6354805/ /pubmed/30815550 http://dx.doi.org/10.1002/edm2.14 Text en © 2018 The Authors. Endocrinology, Diabetes & Metabolism Published by John Wiley & Sons Ltd This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Articles
Clarke, Geoffrey D.
Molina‐Wilkins, Marjorie
Solis‐Herrera, Carolina
Mendez, Verna
Monroy, Adriana
Cersosimo, Eugenio
Chilton, Robert J.
Abdul‐Ghani, Muhammad
DeFronzo, Ralph A.
Impaired left ventricular diastolic function in T2DM patients is closely related to glycemic control
title Impaired left ventricular diastolic function in T2DM patients is closely related to glycemic control
title_full Impaired left ventricular diastolic function in T2DM patients is closely related to glycemic control
title_fullStr Impaired left ventricular diastolic function in T2DM patients is closely related to glycemic control
title_full_unstemmed Impaired left ventricular diastolic function in T2DM patients is closely related to glycemic control
title_short Impaired left ventricular diastolic function in T2DM patients is closely related to glycemic control
title_sort impaired left ventricular diastolic function in t2dm patients is closely related to glycemic control
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6354805/
https://www.ncbi.nlm.nih.gov/pubmed/30815550
http://dx.doi.org/10.1002/edm2.14
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