ABSTRACT
[Abstract] Objective To investigate the early changes of myocardial systolic and diastolic function in patients with type 2 diabetes mellitus (T2DM) and in patients with both T2DM and coronary heart disease (CAD). Methods A retrospective analysis was taken of 128 patients who were hospitalized for suspected CAD, underwent coronary angiography and received echocardiography between August 2015 and November 2017. In these patients, 32 patients with T2DM with normal coronary angiography (DM group), 66 patients with T2DM and CAD (DM+CAD group) and 30 patients with normal coronary angiography without DM (control group) were enrolled in the study. The two-dimensional speckle tracking strain technique was used to measure the global longitudinal peak strain (GLS) of the left ventricular myocardium, and peak systolic longitudinal strains (PSLS) of the basal segment, middle segment and apical segment of the three groups. The further results were compared and analyzed. Generalized linear regression analysis were taken to analyze the factors affecting left ventricular myocardial GLS in the DM patients. Results The interventricular septal (IVS), left ventricular posterior wall (LVPW) and left artrial dimension (LAD) were increased in the DM group and (DM+CAD group), with the E peak and E/A were decreased, compared with the control group. The peak value and E/e' value were higher in the DM+CAD group, compared with the DM group. Importantly, the left ventricular GLS of the DM group, and the DM+CAD group were significantly lower than that of the control group. Moreover, the left ventricular GLS, the basical, the middle and the apical segment PSLS were all significantly lower in the DM+CAD group, than the DM group. In addition, by generalized linear regression analysis, whether combination of coronary heart disease significantly affected GLS value in DM patients, including glycated hemoglobin levels, hypertension, and E/e' values. Conclusion The DM Patients or the patients of DM+CAD were both have left ventricular systolic and diastolic dysfunction in the early stage, even if the ejection fraction is normal. The left ventricular systolic and diastolic dysfunction is more obviously in the DM+CAD patients. The two-dimensional speckle-tracking strain can be used to evaluate left ventricular diastolic and systolic dysfunction in diabetic patients in the early stage.