The Egyptian Heart Journal (Mar 2014)

Right ventricular function in asymptomatic type 2 diabetic patients: A conventional and tissue doppler echocardiographic imaging study

  • Walid Ammar,
  • Salah Abdallah,
  • Hossam EL Hossary,
  • Mohamed Abdel Ghany

DOI
https://doi.org/10.1016/j.ehj.2013.12.058
Journal volume & issue
Vol. 66, no. 1
p. 21

Abstract

Read online

Cardiac adverse effects influenced by diabetes have been demonstrated thus far for the left ventricle. Right ventricular dysfunction is relevant in a variety of disease states affecting both the course and prognosis. Therefore assessment of right ventricular performance is also an important issue in diabetic patients. Aim of the work: To study right ventricular systolic and diastolic functions using conventional and tissue Doppler echocardiographic imaging in asymptomatic type 2 diabetic patients and to assess the relationship of RV functions to diabetes severity and complications. Patients and methods: Fifty patients with type 2 diabetes with no cardiac diseases were prospectively enrolled. The control group included fifteen healthy volunteers. Patients with hypertension, valvular or coronary heart disease were excluded. Full clinical evaluation including fundus examination, laboratory work up including (FBS, HbA1C, hs-CRP, S. creatinine and albuminuria), 12 lead ECG and full conventional and tissue Doppler echocardiographic assessment of both ventricles. Results: Right ventricular diastolic function was abnormal in diabetic group as evidenced by significantly lower values of peak early diastolic velocity Em (p < 0.001) and prolonged IVRT (p < 0.001) compared to control group. A significant reverse relationship between FBS and RV systolic function assessed using fractional area change (r=-0.280,p=0.049). RV diastolic dysfunction was significantly correlated with severity and complications of type 2 DM. 1 – FBS and RV regional IVRT, (r=0.352,p=0.012). 2 – HbA1c and Em of RV, (r=-0.403,p=0.004). 3 – Albuminuria and RV regional IVRT, (p=0.009). 4 – hs-CRP and Am of RV, (r=0.357,p=0.011). Conclusions: Type 2 diabetes mellitus affects right ventricular diastolic function in the presence of normal right ventricular systolic function. Impairment was evident mainly by TDI-derived indices and correlated significantly with severity and complications of type 2 diabetes mellitus.

Keywords