Impact of diabetes mellitus on acute and short term left ventricular longitudinal systolic strain recovery after percutaneous coronary intervention in ischemic hypertensive patients

Abstract

Background: Diabetes mellitus (DM) is linked to an increased risk of cardiovascular disease and almost one-third of patients with acute myocardial infarction (AMI) may have undetected diabetes mellitus (DM) at the time of admission. Objectives: evaluate the impact of DM on the subtle changes in left ventricular (LV) function before and post revascularization in ischemic hypertensive patients. Patients and Methods: This was an observational prospective study performed at Qena University Hospital included 140 ischemic hypertensive patients . Patients were divided into two groups: (1) Diabetic group and (2) non diabetic group. A complete medical history, physical examination and laboratory tests were done as well as Trans thoracic Echocardiography (TTE) was done before and after PCI for each patient. Results: In this study, there was a statistically significant (p-value < 0.05) increase in LV GLS after PCI (-14.0 ± 3.6%) when compared with GLS before PCI (-13.7 ± 1.5%) in diabetic group and highly statistically significant(p-value < 0.001) increased GLS after PCI (-15.8 ± 1.1%) when compared with GLS before PCI (-14.2 ± 0.9%) in non-diabetic group. Also we found that after PCI, diabetic patients had a significant improvement in LV EF and dimensions than the non-diabetic group that resulted in highly significant increase in GLS. Conclusion: The presence of diabetes mellitus in ischemic hypertensive patients had an impact on subclinical LV function that has been improved after successful revascularization regardless the level of HbA1C.

Keywords

• acute coronary syndromes (acs ischemic heart disease (ihd)
• percutaneous coronary intervention (pci)
• global longitudinal strain (gls)
• left ventricle (lv)