Left ventricular metabolic remodeling and accompanied dysfunction in type 2 diabetic patients: A 3D speckle tracking analysis.

PURPOSES: The purposes of our study were to determine the risk factors related to metabolic left ventricular remodeling (LVR) in type 2 diabetes mellitus (T2DM) patients and to assess the LV function with different geometry in such population.

METHODS: Seventy-eight T2DM patients with normal 2D-LVEF (≥55%) were enrolled and divided into two groups with LV normal geometry (LVN) and with LV remodeling (LVR). The control group was composed of forty age- and sex-matched healthy individuals with LVN. A multifactor logistic regression was used to determine the risk factors for LVR, and their diagnostic values were evaluated using the area under the ROC curves (AUC). Three-dimensional speckle tracking echocardiography (3DSTE) was used to measure LV global longitudinal strain (GLS), global circumferential strain (GCS), global area strain (GAS), and global radial strain (GRS).

RESULTS: Fasting plasma glucose (FPG), hyperlipidemia, and BMI were independently associated with LVR in T2DM patients, and the AUC values were 0.699, 0.697, and 0.732, respectively. The T2DM patients with LVN showed significantly lower GLS than the controls (P < 0.05), whereas the T2DM patients with LVR showed significantly lower GLS, GCS, GAS, and GRS than the T2DM patients with LVN (all P < 0.01). Additionally, GLS, GAS, and GRS values decreased significantly in the T2DM patients with LV hypertrophy than in those with LV concentric remodeling (all P < 0.05).

CONCLUSIONS: The routine echocardiography and 3DSTE could be used in combining way to detect the metabolic LV remodeling and accompanied dysfunction in T2DM patients.