Background: Diabetes mellitus is a multi system disorder. Cardiovascular disease particularly coronary heart disease is the major cause of death and morbidity. Two-dimensional myocardial deformation (strain) allows early detection of preclinical myocardial dysfunction like in patients with normal wall motion and systolic function. This study aims to determine if there was a difference in myocardial deformation among diabetic Filipino patients with controlled versus uncontrolled blood glucose.
Methods: There was a total of 57 patient enrolled in this study. Twenty-nine patients with uncontrolled blood glucose and twenty-eight patients with controlled glucose. All subjects have normal wall motion and systolic function. Blood tests such as HbAlc, lipid panels and creatinine were taken. Global longitudinal strain were assessed by two-dimensional echocardiography.
Results: Patients with uncontrolled blood glucose had decreased peak systolic longitudinal strain compared to patients with controlled blood glucose (15.6±0.57%vs 18.03±0.6,p value= 0.0034).There was also an inverse correlation between the levels of HbAlc and the average global longitudinal strain (r=-0.3700, p-value =0.0046). A cut off value for HbA1c level was established to determine preclinical left ventricular systolic dysfunction which is 6.62% with a sensitivity of63.83% and specificity of70%.
Conclusion: Average global longitudinal strain may be an early detector for preclinical myocardial systolic dysfunction in patients with diabetes mellitus despite normal wall motion and LV systolic function. Poor blood glucose control is also correlated with reduced preclinical systolic function.