Myocardial work in hypertensive patients with and without diabetes: An echocardiographic study

Area of Science:

• Cardiology
• Diabetology
• Medical Imaging

Background:

• Hypertension and type 2 diabetes mellitus are prevalent conditions often coexisting.
• Both conditions are known risk factors for cardiovascular disease.
• Assessing myocardial performance in these patient groups is crucial for understanding disease progression and management.

Purpose of the Study:

• To investigate myocardial performance using pressure-strain loops in hypertensive patients with and without type 2 diabetes mellitus.
• To evaluate the impact of hypertension and diabetes on myocardial work parameters.
• To identify associations between clinical parameters and myocardial work.

Main Methods:

• Cross-sectional study including 165 subjects: 55 controls, 60 hypertensive patients without DM, and 50 hypertensive patients with DM.
• Complete two-dimensional echocardiographic examination (2DE) with two-dimensional speckle-tracking echocardiography.
• Pressure-strain curve analysis to determine global myocardial work index, constructive work, wasted work, and work efficiency.

Main Results:

• Left ventricular longitudinal and circumferential strains decreased progressively from controls to hypertensive patients, and further in those with diabetes.
• Global myocardial work index and constructive work significantly increased from controls to hypertensive patients and further in hypertensive patients with diabetes.
• Glycosylated hemoglobin and systolic blood pressure were independently associated with myocardial work parameters.

Conclusions:

• Pressure-strain curve analysis reveals significant alterations in myocardial work due to hypertension and diabetes.
• Type 2 diabetes mellitus exerts an additional detrimental effect on myocardial work in patients with hypertension.
• These findings highlight the complex interplay between hypertension, diabetes, and cardiac function.