The Changes of Right Heart Structure in Patients With Type 2 Diabetes Mellitus / 中国循环杂志

ABSTRACT

Objective: To explore the changes of right heart structure in patients with type 2 diabetes mellitus (T2DM). Methods: A total of 194 T2DM patients were recruited in our research including those complicated with hypertension (HP). The patients were divided into 2 groups T2DM+HP group and T2DM group,n=97 in each group. In addition, there was a Control group composed by 97 healthy subjects from regular physical examination at the same period of time. Right heart structure was assessed and compared by echocardiography in all participants. Results: The pulmonary artery diameter (PAD), right atrial short axis diameter (RA-D1), right atrial long axis diameter (RA-D2) and right atrial area (RAA) were different among 3 groups, allP<0.05. Right ventricular (RV) basal diameter (RV-D1) and RV out flow tract diameter (RVOT1) were similar among different groups,P=0.066 andP=0.059. Compare with Control group, T2DM+HP group had increased RA-D1, RA-D2, RAA and PAD, allP<0.05, while right ventricular free wall thickness was similar between 2 groups; T2DM group showed increased PAD,P<0.05, while RA-D2 was similar,P=0.061. Linear correlation analysis indicated that RV-D1, RVOT1, PA, RA-D1, RA-D2 and RAA were positively related to BMI (r=0.123-0.380) and waist-to-hip ratio (r=0.136-0.325), allP<0.05; RA-D2 and RAA were positively related to natural logarithm of urinary albumin excretion rate (lnUAER) (r=0.172 andr=0.130),P<0.05; PAD was positively related to diastolic blood pressure and E/E' (r=0.154 andr=0.172), negatively related E/A (r=-0.118),P<0.05. Multi regression analysis presented that gender and BMI were independently related to RV-D1, RVOT1, RA-D1, RA-D2 and RAA; BMI and diastolic blood pressure were independently related to PAD; lnUAER was independently related to RAA. Conclusion: T2DM+HP patients had broadened PA and RV basal part, increased RA-D and RAA; the changes of right heart structure were relatively mild in T2DM patients. Elevated blood pressure, BMI and UAER were closely related to the changes of right heart structure in T2DM patients.