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Assessment of left ventricular functions in patients with type 2 diabetes mellitus using tissue Doppler imaging and its correlation with a novel cardiac biomarker

The Egyptian Journal of Internal Medicine volume 29, pages 181–188 (2017)Cite this article

Abstract

Introduction

Cardiovascular diseases account for about 65% of diabetes-related mortality.

Objective

Noninvasive assessment of left ventricular functions in asymptomatic nonhypertensive nonischemic type 2 diabetics using echo heart and tissue Doppler imaging (TDI) for detecting structural and functional cardiac abnormalities, and correlating them with levels of Brain natriuretic peptide (BNP) for early planning of management before passing into overt heart failure (HF) were the objectives of this study.

Patients and methods

We studied 55 patients with type 2 diabetes and classified them into two groups: 26 patients with less than 10 years diabetes duration and 29 patients with more than 10 years duration. Full history, fasting blood glucose, postprandial blood glucose, glycated hemoglobin, creatinine, lipid profile, BNP, ECG, conventional echo, and TDI were performed for all patients.

Results

In all, 45 (80%) patients out of 55 patients have diastolic dysfunction, classified as 15 (27%) with type 1 diastolic dysfunction, 26 (47%) with type 2 pseudonormal diastolic dysfunction, and four (7%) patients with type 3 diastolic dysfunction. Systolic dysfunction (ejection fraction <55) was present in nine (16%) patients despite absent HF. BNP was significantly high in patients with longer diabetes duration (P=0.008). There was a statistically significant difference in the BNP level between those with diminished systolic function and those with normal systolic function, P=0.001; yet no statistically significant difference was found between BNP and different groups of diastolic dysfunction (P=0.7).

Conclusion

Diabetic cardiomyopathy is an important diabetes complication. It varies from subclinical ventricular dysfunction to overt HF. Echocardiography is the standard diagnostic tool for diabetic cardiomyopathy. TDI can be used to quantitatively assess global, regional, systolic, and diastolic myocardial functions. Plasma BNP can be a prognostic rather than diagnostic test.

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Authors and Affiliations

  1. Department of Internal Medicine, Diabetes and Endocrinology, 30 E Thabit Street, Helwan, Cairo, Egypt

    Ebtissam Zakria, Naglaa M. Elsayed, Nashwa S. Ghanem (MD, Assistant Professor) & Elham Youssif

  2. Department of Critical Care Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt

    Mervat M. Kalaf

  3. Department of Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt

    Safaa ElGabarty

Authors
  1. Ebtissam Zakria
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  2. Naglaa M. Elsayed
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  3. Nashwa S. Ghanem
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  4. Elham Youssif
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  5. Mervat M. Kalaf
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  6. Safaa ElGabarty
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Corresponding author

Correspondence to Nashwa S. Ghanem.

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Zakria, E., Elsayed, N.M., Ghanem, N.S. et al. Assessment of left ventricular functions in patients with type 2 diabetes mellitus using tissue Doppler imaging and its correlation with a novel cardiac biomarker. Egypt J Intern Med 29, 181–188 (2017). https://doi.org/10.4103/ejim.ejim_48_17

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