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Coronary flow reserve and myocardial performance index in newly diagnosed diabetic patients
Gülhan Yüksel Kalkan1, Mustafa Gür, Durmuş Yıldıray Şahin
1Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey.
Insights
Newly diagnosed diabetes mellitus patients show reduced coronary flow reserve (CFR) linked to impaired heart function. Myocardial performance index (MPI) is a key indicator of this dysfunction in diabetic individuals.
Area of Science:
- Cardiology
- Diabetology
- Medical Imaging
Background:
- Diabetes mellitus (DM) significantly increases the risk of left ventricular (LV) dysfunction.
- Reduced coronary flow reserve (CFR) is observed in diabetic patients even without coronary artery stenosis.
- Investigating LV systolic and diastolic functions in relation to CFR is crucial for early detection in asymptomatic diabetics.
Purpose of the Study:
- To explore the association between LV myocardial diastolic and systolic functions and CFR.
- To evaluate cardiac function parameters in newly diagnosed diabetic patients.
- To determine the role of myocardial performance index (MPI) in assessing CFR in this population.
Main Methods:
- Transthoracic echocardiography was performed on 88 newly diagnosed DM patients and 40 controls.
- Myocardial performance index (MPI) was measured using pulsed-wave Doppler.
- Coronary flow reserve (CFR) was calculated by comparing hyperemic to resting coronary diastolic peak velocities.
Main Results:
- Diabetic patients exhibited prolonged mitral E-wave deceleration time and higher MPI compared to controls.
- Mean CFR was significantly lower in diabetic patients.
- MPI strongly correlated with CFR, LV ejection fraction, E/A ratio, and glycosylated hemoglobin (HbA1c).
Conclusions:
- Myocardial performance index (MPI) is independently associated with CFR in patients with newly diagnosed diabetes mellitus.
- Decreased CFR may contribute to LV systolic and diastolic dysfunction in asymptomatic diabetic patients.
- MPI serves as a valuable marker for assessing cardiac health in diabetic individuals.
Background:
Patients with diabetes mellitus (DM) are at high risk of left ventricular (LV) dysfunction. A reduction of coronary flow reserve (CFR) has been demonstrated in diabetic patients without coronary artery stenosis. In this study, we investigated the association between LV myocardial diastolic and systolic functions and the CFR in newly diagnosed diabetic patients in the absence of coronary artery disease.
Method:
We studied 88 patients (mean age 49 ± 10 years) with newly diagnosed DM and 40 healthy control subjects (mean age 50 ± 9 years). All subjects underwent transthoracic echocardiography. The myocardial performance index (MPI) was determined by using pulsed-wave Doppler. The CFR was calculated as the hyperemic to resting coronary diastolic peak velocities ratio.
Results:
Patients with diabetes had significantly longer mitral E-wave deceleration time and higher MPI value than control group (P = 0.023 and P < 0.001, respectively). The mean CFR was lower in diabetic patients compared with controls (P = 0.001). The MPI was significantly correlated with CFR (r = -0.371, P < 0.001), LV ejection fraction (r = -0.274, P = 0.018) E/A ratio (r = -0.244, P = 0.024), and glycosylated hemoglobin (HbA1c) (r = 0.476, P < 0.001). Multivariate regression analysis showed that MPI was independently associated with CFR (β = -0.292, P < 0.0001) and HbA1c level (β = 0.372, P < 0.0001).
Conclusions:
The MPI was independently associated with CFR in newly diagnosed diabetic patients. The decrease in CFR may cause LV systolic and diastolic dysfunction in asymptomatic diabetic patients.
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