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Impact of acute hyperglycemia on layer-specific left ventricular strain in asymptomatic diabetic patients: an analysis based on two-dimensional speckle tracking echocardiography.
Bogdanovic, Jelena; Asanin, Milika; Krljanac, Gordana; Lalic, Nebojsa M; Jotic, Aleksandra; Stankovic, Sanja; Rajkovic, Natasa; Stosic, Ljubica; Rasulic, Iva; Milin, Jelena; Popovic, Dragana; Bogdanovic, Ljiljana; Lalic, Katarina.
Afiliação
  • Bogdanovic J; Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, dr Subotica 13, Belgrade, 11000, Serbia.
  • Asanin M; Faculty of Medicine, University of Belgrade, dr Subotica 8, Belgrade, 11000, Serbia.
  • Krljanac G; Clinic for Cardiology, Clinical Center of Serbia, Pasterova 2, Belgrade, 11000, Serbia.
  • Lalic NM; Faculty of Medicine, University of Belgrade, dr Subotica 8, Belgrade, 11000, Serbia.
  • Jotic A; Clinic for Cardiology, Clinical Center of Serbia, Pasterova 2, Belgrade, 11000, Serbia.
  • Stankovic S; Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, dr Subotica 13, Belgrade, 11000, Serbia.
  • Rajkovic N; Faculty of Medicine, University of Belgrade, dr Subotica 8, Belgrade, 11000, Serbia.
  • Stosic L; Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, dr Subotica 13, Belgrade, 11000, Serbia.
  • Rasulic I; Faculty of Medicine, University of Belgrade, dr Subotica 8, Belgrade, 11000, Serbia.
  • Milin J; Center for Medical Biochemistry, Clinical Center of Serbia, Pasterova 2, Belgrade, 11000, Serbia.
  • Popovic D; Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, dr Subotica 13, Belgrade, 11000, Serbia.
  • Bogdanovic L; Faculty of Medicine, University of Belgrade, dr Subotica 8, Belgrade, 11000, Serbia.
  • Lalic K; Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, dr Subotica 13, Belgrade, 11000, Serbia.
Cardiovasc Diabetol ; 18(1): 68, 2019 06 03.
Article em En | MEDLINE | ID: mdl-31159858
ABSTRACT

BACKGROUND:

Hyperglycemia has detrimental effect on ischemic myocardium, but the impact of acute hyperglycemia on the myocardium in asymptomatic diabetic patients has not been fully elucidated. Thus, this follow-up study was aimed to investigate the effects and reversibility of acute hyperglycemia on regional contractile function of left ventricle (LV) in diabetic patients without cardiovascular disease.

METHODS:

The two-dimensional speckle tracking echocardiography (2D-STE), including multilayer strain analysis, was used for evaluation of global and regional LV function in asymptomatic, normotensive patients with uncomplicated diabetes, with acute hyperglycemia ( ≥ 11.1 mmol/l) (Group A, n = 67), or with optimal metabolic control (fasting plasma glucose < 7 mmol/l and HbA1c < 7%) (Group B, n = 20), while 20 healthy individuals served as controls (Group C). In group A, after 72 h of i.v. continuous insulin treatment (at the time euglycemia was achieved) (second examination) and after 3 months following acute hyperglycemia (third examination) 2D-STE was repeated.

RESULTS:

Global longitudinal strain (GLS) (- 19.6 ± 0.4%) in Group A was significantly lower in comparison to both groups B (- 21.3 ± 0.4%; p < 0.05) and C (- 21.9 ± 0.4%; p < 0.01) at baseline, while we could not detect the differences between groups B and C. Peak systolic longitudinal endocardial (Endo), mid-myocardial (Mid) and epicardial (Epi) layer strain were significantly lower in group A at baseline compared to both groups B and C. Deterioration in peak systolic circumferential strain was observed at basal LV level, in all three layers (Endo, Mid and Epi) and in mid-cavity LV level in Epi layer in group A in comparison to group C. Moreover, in group A, after euglycemia was achieved (at second and third examination) GLS, as well as peak longitudinal and circumferential strain remain the same.

CONCLUSION:

Acute hyperglycemia in asymptomatic diabetic patients has significant negative effects on systolic LV myocardial mechanics primarily by reducing GLS and multilayer peak systolic longitudinal and circumferential strain which was not reversible after three months of good glycemic control.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Glicemia / Ecocardiografia Doppler / Função Ventricular Esquerda / Disfunção Ventricular Esquerda / Diabetes Mellitus / Cardiomiopatias Diabéticas / Contração Miocárdica Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Cardiovasc Diabetol Assunto da revista: ANGIOLOGIA / CARDIOLOGIA / ENDOCRINOLOGIA Ano de publicação: 2019 Tipo de documento: Article País de publicação: ENGLAND / ESCOCIA / GB / GREAT BRITAIN / INGLATERRA / REINO UNIDO / SCOTLAND / UK / UNITED KINGDOM

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Glicemia / Ecocardiografia Doppler / Função Ventricular Esquerda / Disfunção Ventricular Esquerda / Diabetes Mellitus / Cardiomiopatias Diabéticas / Contração Miocárdica Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Cardiovasc Diabetol Assunto da revista: ANGIOLOGIA / CARDIOLOGIA / ENDOCRINOLOGIA Ano de publicação: 2019 Tipo de documento: Article País de publicação: ENGLAND / ESCOCIA / GB / GREAT BRITAIN / INGLATERRA / REINO UNIDO / SCOTLAND / UK / UNITED KINGDOM