Assessment of subclinical left ventricular systolic dysfunction in patients with type 2 diabetes: Relationship with HbA1c and microvascular complications

• Published in: Journal of diabetes Vol. 15; no. 3; pp. 264 - 274
• Main Authors: Chen, Yanyan, Zhang, Ying, Wang, Yi, Ta, Shengjun, Shi, Min, Zhou, Yingni, Li, Mengying, Fu, Jianfang, Wang, Li, Liu, Xiangyang, Lu, Zuowei, Liu, Liwen, Li, Zeping, Zhou, Jie, Li, Xiaomiao
• Format: Journal Article
• Language: English
• Published: Australia John Wiley & Sons, Inc 01.03.2023; Wiley Publishing Asia Pty Ltd
• Subjects: Asymptomatic; Cardiovascular disease; Diabetes; Diabetes Mellitus, Type 2 - complications; Diabetic retinopathy; Glycated Hemoglobin; Humans; Original; Risk Factors; Ventricular Dysfunction, Left - diagnosis; Ventricular Dysfunction, Left - etiology; Ventricular Function, Left - physiology; global longitudinal strain; 全局纵向应变; 心室功能; glycated hemoglobin; ventricular function; type 2 diabetes mellitus; 微血管并发症; microvascular complications; 糖化血红蛋白; 2型糖尿病
• ISSN: 1753-0393; 1753-0407
• DOI: 10.1111/1753-0407.13369

We aimed to examine the association between glycated hemoglobin (HbA1c), microvascular complications, and subclinical left ventricular (LV) systolic dysfunction, and to determine the strength of the correlation in asymptomatic patients with type 2 diabetes mellitus (T2DM). Global longitudinal strain (GLS) was employed to assess the subclinical LV function of 152 enrolled T2DM patients with preserved LV ejection fraction, with the cutoff for subclinical LV systolic dysfunction predefined as GLS < 18%. According to univariate analysis, the reduced GLS exhibited association with the clinical features including HbA1c, triglyceride, systolic blood pressure, fasting glucose, heart rate, diabetic retinopathy, and urinary albumin creatinine ratio (UACR) (all p < .05). After the factors of gender, age, and related clinical covariables adjusted, multiple logistic regression analysis revealed the HbA1c (odds ratio [OR] 1.66; 95% confidence interval [CI] 1.30-2.13; p < .001), UACR (OR 2.48; 95% CI 1.12-5.47; p = .025) and triglyceride (OR 1.84; 95% CI 1.12-3.03; p = .017) as the independent risk factors for the reduced GLS. Receiver operating characteristic curve showed a predictive value of the HbA1c for the subclinical LV systolic dysfunction (area under curve: 0.74; p < .001). In asymptomatic T2DM patients, subclinical LV systolic dysfunction was associated with HbA1c, diabetic complications, and triglyceride. More prominently, HbA1c may exert a prognostic significance for the progression of myocardial damage.