糖尿病患者左心室三维应变和微血管并发症的相关性研究

Study of correlation between left ventricle myocardial three-dimensional stain and complications of microangiopathy in type 2 diabetes patients

目的探讨2型糖尿病患者微血管并发症与左心室三维应变的关系。方法选择45例无症状2型糖尿病患者和41例年龄、性别与其相匹配的健康志愿者作为研究对象。获取两组三维左心室全容积图像,采用三维斑点追踪技术测量两组左心室整体纵向应变(GLS)、整体面积应变(GAS)、整体径向应变(GRS)以及整体圆周应变(GCS)。结果两组左心室射血分数(LVEF)、左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)以及GRS差异无统计学意义(P>0.05)。与对照组比较,糖尿病患者左心室GLS、GAS以及GCS显著减低(P<0.05)。糖尿病组GLS与微血管并发症评分呈线性相关(r=0.610,P<0.01)。结论糖尿病患者微血管并发症与亚临床左心室功能障碍显著相关,左心室纵向功能的受损是其显著特征。

Objective The aim of this study was to assess the relation between diabetic microvascular complications and left ventricle myocardial three-dimensional stain in type 2 diabetes patients. Methods Forty-five asymptomatic patients with type 2diabetes mellitus（2DM） and Forty-one age-matched healthy control subjects underwent 3D echocardiography. Presence of proliferative retinopathy,nephropathy,and cardiac autonomic neuropathy were defined as diabetic microvascular complications.Echocardiogram images of the short axis of the left ventricle and apical long axis were obtained. The three-dimensional speckle tracking echocardiography was used to analyze the left ventricular global longitudinal strain（GLS）,globalendocardial area strain（GAS）,global circumferential strain（GCS） and the global radial strain（GRS）. Results LVEF,LVEDV,LVESV,and GRS were similar between controls and DM patients（P〉0.05）. However,compared to controls,GLS,GCS and GAS were significantly reduced in patients with DM patients（P〈0.05）. In DM patients,GLS was related to microangiopathy burden score（r = 0.610,P〈0.01）.Conclusion Microvascular complications in diabetic patients are significantly associated with subclinical left ventricular dysfunction that is characterized by impaired left ventricular longitudinal function.