Assessment of left and right ventricular function and mechanical dispersion by using two dimensional speckle tracking echocardiography in young asymptomatic subjects with diabetes mellitus type 1

Introduction: Diabetes mellitus type 1 (DM1) is asso-ciated with high risk for premature onset of heart di-sease therefore early detection of myocardial dysfunc-tion is of crucial importance.

Objective: We aimed to evaluate the ability of multi-la-yer speckle tracking echocardiography (STE) to detect myocardial dysfunction in young asymptomatic adults with diabetes mellitus type 1.

Methods: We included 50 patients with DM1 (30.1 ± 5.3 years, 26 males) with an average time from diagnosis of 9 ± 6 years and 80 healthy subjects (28.7 ± 4.8 years, 45 males). Left ventricular (LV) function and structu-re was analyzed using both conventional and speckle tracking echocardiography. The LV longitudinal layer-specific strains (LS) of the endocardium (GLSendo), myocardium (GLSmyo), and epicardium (GLSepi), LV mechanical dispersion (LV MD; standard deviation of the time to peak maximum LS) as well as LV circum-ferential strain (CS) and LV torsion were calculated. Right ventricular (RV) global (RV GLS) and free wall strain (RV FWLS) and RV MD were also obtained.

Results: LV mass indexed was higher in the DM1 group (77 ± 20 vs. 65 ± 14 g/m2, p<0.01) and no significant in-tergroup differences in LV ejection fraction were noted (60 ± 7 vs. 58 ± 4, p=ns). GLSendo, GLSmyo were lower in the DM1 group (−20.6 ± 2.7 vs. −22.0 ± 2.3 and −18.0 4 vs. −19.1 ± 1.9, p<0.05) while GLSepi, LV CS and torsion showed no significant differences. Mechanical dispersion was higher in the diabetes group (34 ± 11 vs. 29 ± 7, p<0.05). RV strain measurements were slightly, but not significantly reduced in subjects with DM1 (RV GLS, −22.0 ± 4.1 vs. −22.9 ± 3.2, p=ns; RV FWLS, −26.4 2 vs. −27.5 ± 3.9, p=ns). RV mechanical dispersion showed similar values for both groups (23 ± 2 vs. 20 ± 2, p=ns).

Conclusions: Young asymptomatic subjects with dia-betes mellitus type 1 present with subtle left ventricular dysfunction identified by multi-layer 2D STE and pre-served right ventricular function.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)