Linking the heart and brain in type 2 diabetes: association between global longitudinal strain and cognitive function

Area of Science:

• Cardiology
• Neurology
• Endocrinology

Background:

• Cognitive impairment is a common complication in type 2 diabetes (T2DM).
• Global longitudinal strain (GLS) indicates subclinical left ventricular systolic dysfunction and is linked to cardiovascular outcomes in T2DM.
• The relationship between GLS and cognitive performance in T2DM patients is not well understood.

Purpose of the Study:

• To investigate the association between GLS and cognitive function in patients with T2DM.
• To determine if GLS is an independent predictor of cognitive impairment in T2DM.

Main Methods:

• Prospective enrollment of 234 T2DM patients without significant carotid stenosis, stroke history, or severe hypoglycemia.
• Cognitive function assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS).
• GLS measured by speckle-tracking echocardiography; multivariable linear regression used for analysis.

Main Results:

• 19.7% of patients had borderline/impaired cognition (RBANS score <80).
• 29.1% exhibited subclinical LV dysfunction (GLS ≥ -18%).
• Impaired GLS was independently associated with lower RBANS scores, even after adjustments and exclusions, and was more pronounced in those with lower education.

Conclusions:

• Impaired GLS is independently associated with reduced cognitive performance in T2DM patients.
• GLS may serve as a marker for cognitive decline in T2DM, irrespective of left ventricular ejection fraction.
• Further research into the mechanisms linking cardiac dysfunction and cognitive impairment in T2DM is warranted.