ABSTRACT
Background: The cardiac changes associated with diabetes are thought to comprise thickening of the myocardium and is characterized by predominantly diastolic dysfunction (DD), the diabetic cardiomyopathy. So, this study aimed to evaluate cardiac impairments in patients in delta region with type 2 diabetes mellitus using resting electrocardiogram (ECG) and resting transthoracic echocardiography. Methods: This was a cross-sectional study carried out on 50 diabetic patients to evaluate of cardiac impairments in patients in delta region with type 2 diabetes mellitus using resting ECG and resting transthoracic echocardiography at the Department of Cardiology, Tanta University Hospitals in a period of six months starting from January 2020 till June 2020. Results: There were significant negative correlations between abnormal echocardiography with (body mass index) BMI, duration of diabetes and systolic blood pressure (SBP) (P<0.05). The sensitivity of ejection fraction (EF), early trans-mitral flow velocity (E), atrial trans-mitral flow velocity (A) and E/A in detecting cardiac changes in type 2 diabetes mellitus (DM) was 68%, 52%, 76%, 72% and specificity was 52%, 68%, 36%, 30% at cut-off value 65, 75, 65, 77.5 and AUC 0.619, 0.606, 0.538, 0.534, respectively (P> 0.05). Conclusions: The effect of DM on the left ventricular (LV) diastolic function is still controversial. Therefore, they need to be further substantiated, preferably with evidence from extensive longitudinal studies in people with type 2 diabetes representative of type 2 diabetes healthcare populations. Echocardiographic and ECG abnormalities are very common in outpatients with type 2 diabetes. DD is the main cardiac impairment caused by DM.
ABSTRACT
Background: Atrial septal defects lead to left to right shunt, the volume of the shunt is determined by RV/LV compliance, defect size, and LA/RA pressure. RV volume overload and pulmonary over circulation are caused by a simple ASD because the RV is more compliant than the LV. The aim of our study was to assess changes in RV systolic function before and after ASD closure either by surgery or transcatheter closure. Methods: This study was conducted on 70 patients diagnosed with ASD Secundum and had subdivided into two groups A (surgical closure) group, and B (percutaneous device closure) group. All patients had been assessed by transthoracic Echocardiography examination for RV systolic Function 24 h before ASD closure, and 6 months after closure. Results: There was a significant decrease in the right ventricle systolic function indices (TAPSE, FAC, Tissue Doppler S wave velocity, and global longitudinal free wall strain) after ASD closure either by surgery or by transcatheter device closure Conclusions: The right ventricle's size and function are affected by a large shunt caused by an ASD secudium. ASD and its consequent volume overload resulted in higher RV myocardial contraction, leading to an increase in strain values and RV systolic function indices, which were reduced and returned to normal values when the left-to-right shunt was eliminated, and the defect was closed.