Assessment on right ventricular longitudinal strain and strain rate in prediabetes with two-dimensional speckle tracking imaging

doi:10.3877/cma.j.issn.1672-6448.2018.01.009

Abstract

Abstract:

Objective

To predict the presence of impairment of right ventricular function in prediabetes using two-dimensional speckle tracking imaging.

Methods

From June 2012 to May 2016, a total of 110 patients from Zhejiang Taizhou Hospital of Taizhou Enze Medical Center (group) were recruited, including 40 controls, 33 prediabetes and 37 type 2 diabetes. The routine right ventricular parameters were measured. Longitudinal peak strain of right ventricular free wall (RVLPSF), ventricular septal (RVLPSS) and global longitudinal peak strain of right ventricle (RVLPSG) were measured with two-dimensional spekle tracking imaging, and global systolic strain rate (SRS), global early diastolic strain rate (SRE) and global late diastolic strain rate (SRL) of right ventricle were also measured. LVEDVI, LVESVI, LVEF, RVD, E/A, e/a, E/e, TAPSE, RVFAC, RVLPSF, RVLPSS, RVLPSG, SRS, SRE, and SRL in the above 3 groups were analyzed with LSD-t test.

Results

Compared with the controls: RVLPSF, RVLPSS, RVLPSG, SRS, and SRE were all statistically reduced in prediabetes [(-27.89±4.11)% vs (-21.78±3.62)%, (-20.08±4.11)% vs (-16.88±2.68)%, (-23.98±2.96)% vs (-19.33±2.13)%, -1.67±0.25 vs -1.18±0.24, and 1.84±0.23 vs 1.35±0.20, t=3.45, 3.42, 3.44, 3.44, and 3.43, all P<0.01]. RVLPSF, RVLPSS, RVLPSG, SRS, and SRE were all statistically reduced in diabetes [(-27.89±4.11)% vs (-20.97±3.88)%, (-20.08±4.11)% vs (-15.42±1.92)%, (-23.98±2.96)% vs (-18.19±2.29)%, -1.67±0.25 vs -1.08±0.23, and 1.84±0.23 vs 1.18±0.27, t=3.43, 3.45, 3.43, 3.42, and 3.42, all P<0.01]. Compared the prediabetes: SRE was significantly reduced in diabetes (1.35±0.20 vs 1.18±0.27, t=3.45, P<0.01).

Conclusions

Diastolic and systolic function of right ventricle were already impaired in prediabetes, and speckle tracking imaging can quantitatively evaluate the impairment.

Key words: Prediabetic state, Ventricular function, right, Ultrasonography

Xing′an Yang, Weixing Pan, Jia Zhu. Assessment on right ventricular longitudinal strain and strain rate in prediabetes with two-dimensional speckle tracking imaging[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2018, 15(01): 48-52.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2018.01.009

https://chaosheng.cma-cmc.com.cn/EN/Y2018/V15/I01/48

Figures/Tables 5

References 15

1	American Diabetes Association. Standards of medical care in diabetes-2017 [J]. Diabetes Care, 2017, 40(Suppl 1):S1-S135.
2	Stahrenberg R, Edelmann F, Mende M, et al. Association of glucose metabolism with diastolic function along the diabetic contimuum [J]. Diabetologia, 2010, 53(7):1331-1340.
3	薛衍敏，潘翠珍，李政, 等. 分层二维斑点追踪显像技术评价糖尿病患者左室心肌各层收缩功能的变化 [J]. 中华超声影像学杂志, 2015, 24(12):1024-1027.
4	Voulgari C, Papadogiannis D, Tentolouris N. Diabetic cardiomyopathy: from the pathophysiology of the cardiac myocytes to current diagnosis and management strategies [J]. Vasc Health Risk Manag, 2010, 6:883-903.
5	刘江燕，芦芳. 斑点追踪显像技术评价糖尿病心肌病患者左心室功能研究进展 [J/CD]. 中华医学超声杂志(电子版), 2016, 13(10):797-800.
6	Wang Q, Gao Y, Tan K, et al. Assessment of left ventricular function by three-dimensional speckle-tracking echocardiography in well-treated type 2 diabetes patients with or without hypertension [J]. J Clin Ultrasound, 2015, 43(8):502-511.
7	王婉露，章仁品，陈永, 等. 二维斑点追踪技术评价2型糖尿病患者左室舒张功能的价值 [J]. 中国心血管病研究, 2017, 15(3):260-264.
8	杨勇，吕秀花，王臻, 等. 二维斑点追踪技术在评价糖尿病患者左心室整体与节段长轴收缩功能 [J]. 中国超声医学杂志, 2015, 31(3):218-220.
9	高磊，刘昕，郭淑芹, 等. 实时三维斑点追踪成像评价2型糖尿病血糖控制不良患者左心室整体收缩功能 [J]. 中国医学影像学杂志, 2015, 23(6):439-443, 448.
10	闻小林，王玲，郑言言, 等. 二维斑点追踪成像技术评价2型糖尿病患者右室心肌纵向应变及应变率 [J]. 中华超声影像学杂志, 2012, 21(9):762-766.
11	俞霏，许幼峰，毛锋, 等. 二维斑点追踪成像评估2型糖尿病患者右心室功能 [J]. 中华超声影像学杂志, 2015, 24(8):657-660.
12	O′Neill BT, Abel ED. Akt1 in the cardiovascular system: friend or foe? [J]. J Clin Invest, 2005, 115(8):2059-2064.
13	Kern W, Peters A, Born J, et al. Changes in blood pressure and plasma catecholamine levels during prolonged hyperinsulinemia [J]. Metabolism, 2005, 54(3):391-396.
14	Tarquini R, Lazzeri C, Pala L, et al. The diabetic cardiomyopathy [J]. Acta Diabetol, 2011, 48(3):173-181.
15	Vittos O, Toana B, Vittos A. Biomarkers and their involvement in the early diagnosis of right ventricular dysfunction in type 2 diabetes mellitus [J]. J Med Life, 2012, 5(1):74-78.

组别	例数	年龄（岁，±s）	男/女（例）	吸烟史[例（%）]	心率（次/min，±s）	收缩压（mmHg，±s）	舒张压（mmHg，±s）
健康对照组	40	56.94±5.58	22/18	13（32.5%）	71±8	120±13	70±8
糖尿病前期组	33	58.89±6.00	17/16	12（36.4%）	72±7	123±11	72±7
糖尿病组	37	56.51±7.08	20/17	15（40.5%）	73±5	125±11	72±8
统计值	?	F=1.41	χ²=0.09	χ²=0.53	F=1.12	F=1.50	F=0.62
P值	?	0.25	0.96	0.77	0.33	0.23	0.54

组别	例数	年龄（岁，±s）	男/女（例）	吸烟史[例（%）]	心率（次/min，±s）	收缩压（mmHg，±s）	舒张压（mmHg，±s）
健康对照组	40	56.94±5.58	22/18	13（32.5%）	71±8	120±13	70±8
糖尿病前期组	33	58.89±6.00	17/16	12（36.4%）	72±7	123±11	72±7
糖尿病组	37	56.51±7.08	20/17	15（40.5%）	73±5	125±11	72±8
统计值	?	F=1.41	χ²=0.09	χ²=0.53	F=1.12	F=1.50	F=0.62
P值	?	0.25	0.96	0.77	0.33	0.23	0.54

组别	例数	LVEDVI（m³/m²）	LVESVI（m³/m²）	LVEF（%）	RVD（mm）	E/A	e/a	E/e	TAPSE（mm）	RVFAC（%）
健康对照组	40	82.05±11.58	28.74±5.73	63.24±4.59	29.30±2.17	1.52±0.23	0.81±0.09	3.60±0.51	23.16±3.58	44.33±4.41
糖尿病前期组	33	85.78±11.02	29.92±6.35	65.12±6.08	29.15±1.49	1.22±0.26^a	0.79±0.10	4.62±1.16^a	22.00±3.32	44.91±5.61
糖尿病组	37	85.49±10.23	30.33±6.26	64.52±5.18	29.97±1.34	0.79±0.21^bc	0.77±0.10	4.71±2.19^b	21.66±3.05	43.24±6.18
F值	?	1.36	0.71	1.25	2.27	93.90	1.85	6.96	1.88	0.87
P值	?	0.26	0.50	0.29	0.11	<0.01	0.16	<0.01	0.15	0.42

组别	例数	LVEDVI（m³/m²）	LVESVI（m³/m²）	LVEF（%）	RVD（mm）	E/A	e/a	E/e	TAPSE（mm）	RVFAC（%）
健康对照组	40	82.05±11.58	28.74±5.73	63.24±4.59	29.30±2.17	1.52±0.23	0.81±0.09	3.60±0.51	23.16±3.58	44.33±4.41
糖尿病前期组	33	85.78±11.02	29.92±6.35	65.12±6.08	29.15±1.49	1.22±0.26^a	0.79±0.10	4.62±1.16^a	22.00±3.32	44.91±5.61
糖尿病组	37	85.49±10.23	30.33±6.26	64.52±5.18	29.97±1.34	0.79±0.21^bc	0.77±0.10	4.71±2.19^b	21.66±3.05	43.24±6.18
F值	?	1.36	0.71	1.25	2.27	93.90	1.85	6.96	1.88	0.87
P值	?	0.26	0.50	0.29	0.11	<0.01	0.16	<0.01	0.15	0.42

组别	例数	RVLPSF（%）	RVLPSS（%）	RVLPSG（%）	SRS（s^-1）	SRE（s^-1）	SRA（s^-1）
健康对照组	40	-27.89±4.11	-20.08±4.11	-23.98±2.96	-1.67±0.25	1.84±0.23	1.33±0.22
糖尿病前期组	33	-21.78±3.62^a	-16.88±2.68^a	-19.33±2.13^a	-1.18±0.24^a	1.35±0.20^a	1.31±0.20
糖尿病组	37	-20.97±3.88^b	-15.42±1.92^b	-18.19±2.29^b	-1.08±0.23^b	1.18±0.27^bc	1.29±0.28
F值	?	36.30	22.98	57.47	69.20	79.50	0.18
P值	?	<0.01	<0.01	<0.01	<0.01	<0.01	0.83

Please choose a citation manager

Content to export