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Early detection of diabetic cardiomyopathy: usefulness of tissue Doppler imaging
Author(s) -
Bonito P.,
Moio N.,
Cavuto L.,
Covino G.,
Murena E.,
Scilla C.,
Turco S.,
Capaldo B.,
Sibilio G.
Publication year - 2005
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2005.01685.x
Subject(s) - medicine , diabetic cardiomyopathy , doppler imaging , cardiology , diastole , insulin resistance , cardiac function curve , diabetes mellitus , type 2 diabetes , endocrinology , cardiomyopathy , hypertrophic cardiomyopathy , insulin , heart failure , blood pressure
Objective The aim of the study was to evaluate whether tissue Doppler imaging (TDI) detects a pre‐clinical impairment of diastolic function in subjects with Type 2 diabetes with short duration of disease and normal cardiac function with conventional echocardiography (CE), and whether echocardiographic parameters are related to metabolic abnormalities. Patients and methods We studied 40 non‐obese, normotensive, uncomplicated Type 2 diabetic subjects with short duration of disease and 20 control subjects. All participants underwent both CE and TDI echocardiography. With TDI, early velocity (Ea), atrial velocity (Aa), their ratio (Ea/Aa) and systolic velocity (Sa) were measured at the lateral corner of mitral annulus. Glycosylated haemoglobin, fasting plasma glucose and insulin were determined and homeostasis model assessment (HOMA‐IR), as an index of insulin resistance, was calculated. Results Cardiac function with CE was similar in the two groups. Using TDI, diabetic subjects showed a lower Ea velocity (15.5 ± 3.9 vs. 19.4 ± 3.5 cm/s, P < 0.0001), an increased Aa velocity (15.5 ± 2.4 vs. 14.1 ± 2.4 cm/s, P < 0.05) and a reduced Ea/Aa ratio (1.00 ± 0.2 vs. 1.39 ± 0.3, P < 0.0001), compared with control subjects. Linear regression analysis in the diabetic group showed that only HOMA‐IR was negatively associated with Ea/Aa ratio ( P = 0.026). No significant association was observed with other metabolic variables. Conclusion An early stage of diabetic cardiomyopathy can be evidenced by TDI in Type 2 diabetic subjects even in the presence of a normal cardiac function with CE. This abnormality is associated with insulin resistance.