Open AccessRight ventricular function in asymptomatic type 2 diabetic patients: A conventional and tissue doppler echocardiographic imaging study
Author(s) -
Walid Ammar,
Salayna Abdallah,
Hossam El Hossary,
Mohamed Abdel Ghany
Publication year - 2014
Publication title -
the egyptian heart journal /the egyptian heart journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.212
H-Index - 9
eISSN - 2090-911X
pISSN - 1110-2608
DOI - 10.1016/j.ehj.2013.12.058
Subject(s) - medicine , cardiology , asymptomatic , doppler imaging , diastole , ventricle , albuminuria , tissue doppler echocardiography , diabetes mellitus , doppler echocardiography , ejection fraction , valvular heart disease , type 2 diabetes , renal function , heart failure , blood pressure , diastolic function , endocrinology
Cardiac adverse effects influenced by diabetes have been demonstrated thus far for the left ventricle. Right ventricular dysfunction is relevant in a variety of disease states affecting both the course and prognosis. Therefore assessment of right ventricular performance is also an important issue in diabetic patients.Aim of the work: To study right ventricular systolic and diastolic functions using conventional and tissue Doppler echocardiographic imaging in asymptomatic type 2 diabetic patients and to assess the relationship of RV functions to diabetes severity and complications.Patients and methods: Fifty patients with type 2 diabetes with no cardiac diseases were prospectively enrolled. The control group included fifteen healthy volunteers. Patients with hypertension, valvular or coronary heart disease were excluded. Full clinical evaluation including fundus examination, laboratory work up including (FBS, HbA1C, hs-CRP, S. creatinine and albuminuria), 12 lead ECG and full conventional and tissue Doppler echocardiographic assessment of both ventricles.Results: Right ventricular diastolic function was abnormal in diabetic group as evidenced by significantly lower values of peak early diastolic velocity Em (p < 0.001) and prolonged IVRT (p < 0.001) compared to control group. A significant reverse relationship between FBS and RV systolic function assessed using fractional area change (r=-0.280,p=0.049). RV diastolic dysfunction was significantly correlated with severity and complications of type 2 DM. 1 – FBS and RV regional IVRT, (r=0.352,p=0.012). 2 – HbA1c and Em of RV, (r=-0.403,p=0.004). 3 – Albuminuria and RV regional IVRT, (p=0.009). 4 – hs-CRP and Am of RV, (r=0.357,p=0.011).Conclusions: Type 2 diabetes mellitus affects right ventricular diastolic function in the presence of normal right ventricular systolic function. Impairment was evident mainly by TDI-derived indices and correlated significantly with severity and complications of type 2 diabetes mellitus