European Journal of Echocardiography Advance Access originally published online on June 18, 2009
European Journal of Echocardiography 2009 10(7):841-846; doi:10.1093/ejechocard/jep086
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Tissue Doppler imaging must be performed to detect early left ventricular dysfunction in patients with type 1 diabetes mellitus
1 Department of Endocrinology and Metabolism, Ankara Numune Education and Research Hospital, Ankara, Turkey
2 Department of Cardiology, Ankara Numune Education and Research Hospital, Ankara, Turkey
3 Department of Cardiology, Tatvan Military Hospital, Bitlis, Turkey
4 Department of Clinical Biochemistry, Ankara Numune Education and Research Hospital, Ankara, Turkey
Received 13 March 2009; accepted after revision 23 May 2009; online publish-ahead-of-print 18 June 2009.
* Corresponding author. Tel: +90 505 486 22 75; fax: +90 434 825 69 16. E-mail address: kacmazfehmi{at}superonline.com or drfehmikacmaz{at}yahoo.com
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Abstract |
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Aims: We sought to compare diastolic parameters in patients having type 1 diabetes mellitus (DM) and healthy controls using both pulse-wave (PW) Doppler and relatively novel tissue-Doppler imaging (TDI) to evaluate the possible effect of diabetes on left ventricular dysfunction.
Methods and results: One hundred and thirty-two patients were evaluated (81 type 1 diabetic patients and 51 healthy volunteers). The detailed M-mode, two-dimensional, colour Doppler; PW Doppler; and TDI analyses were performed on resting subjects in a regular setting. Posterior wall thickness, left atrial indexed diameter, and A velocity were significantly higher in the diabetics when compared with control group (P = 0.019, <0.001, 0.033, respectively). Rest of the M-mode and PW Doppler parameters of diabetics were comparable with those of control subjects (P > 0.05 for all). However, both septal E' and lateral E' velocities were significantly lower in diabetics than in the control subjects on TDI echocardiographic examination (P < 0.001 and 0.011, respectively). In addition, E'/septal E' and E/lateral E' ratios were significantly higher in the diabetic group (P < 0.001 and 0.008, respectively).
Conclusion: TDI is a more accurate and powerful method than PW or M-mode in determination of early cardiac involvement related to type 1 DM even in the subclinical phase as well as hereditary cardiomyopathies.
Keywords: Type 1 diabetes mellitus; Diastolic dysfunction; Pulse-wave Doppler; Tissue-Doppler imaging
This study has been accepted as poster presentation at Congress on Clinical Vascular Biology 2007, Antalya, Turkey and abstract has been published at European Journal of Clinical Investigation.