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Patients with Diabetes and Significant Epicardial Coronary Artery Disease Have Increased Systolic Left Ventricular
Ravi Rasalingam1, Mark R Holland2, Daniel H Cooper3
1Cardiovascular Division, Boston Veterans Affairs Medical Center, West Roxbury, Massachusetts.
Echocardiography (Mount Kisco, N.Y.)
|November 24, 2015
Summary
Diabetic patients with significant coronary artery disease (CAD) show altered myocardial rotation and rotation rate. Echocardiography can detect these changes noninvasively, aiding early diagnosis in this population.
Area of Science:
- Cardiology
- Diabetology
- Medical Imaging
Background:
- Diabetes mellitus is a significant risk factor for cardiovascular disease.
- Coronary artery disease (CAD) in diabetic patients often presents with atypical symptoms.
- Assessing myocardial function in diabetic patients with CAD and normal ejection fraction is crucial.
Purpose of the Study:
- To investigate alterations in resting myocardial deformation and rotation in diabetic patients with significant epicardial CAD.
- To determine if echocardiography can detect these changes in patients with normal left ventricular ejection fraction.
Main Methods:
- Prospective observational study involving 84 diabetic patients.
- Resting echocardiography using speckle tracking to measure longitudinal strain, strain rate, apical rotation, and rotation rate.
- Comparison of echocardiographic parameters between patients with and without significant epicardial CAD confirmed by cardiac catheterization.
Main Results:
- Significant epicardial CAD was identified in 46.4% of patients.
- Patients with CAD showed significantly increased global peak systolic apical rotation (14.9 ± 5.1 vs. 11.0 ± 4.8 degrees, P < 0.001).
- Faster peak systolic apical rotation rate was observed in patients with CAD (90.4 ± 29 vs. 68.1 ± 22.2 degrees/sec, P < 0.001).
Conclusions:
- Diabetic patients with significant epicardial CAD and normal LVEF exhibit increased apical rotation and rotation rate.
- These findings suggest that echocardiography can noninvasively detect myocardial effects of CAD in diabetic patients at rest.
- Speckle tracking echocardiography may serve as a valuable tool for early detection of subclinical myocardial dysfunction in this high-risk group.
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