Abstract

Objectives

The purpose of this study was to evaluate the early alterations of left ventricular (LV) structure and function in type 2 diabetes mellitus (T2DM) patients with or without obstructive sleep apnoea (OSA) using 3 D speckle tracking echocardiography (3DSTE).

Methods

Eighty T2DM patients with preserved LVEF were included, half of whom had OSA as co-morbidity. Forty age- and sex-matched controls were also enrolled. LV structure and function were evaluated by conventional echocardiography and 3DSTE. LV global longitudinal strain (GLS), global circumferential strain (GCS), global area strain (GAS), and global radial strain (GRS) were all measured by 3DSTE.

Results

Four geometric patterns (normal geometry, concentric remodelling, concentric and eccentric hypertrophy) occupied significantly different proportions within the three groups (p = .014). LV remodelling made up higher shares in two T2DM groups than in the controls, whereas LV hypertrophy appeared most frequently in the patients with T2DM and OSA. The patients with T2DM alone had significantly lower GLS and GCS than the controls (both p < .01). The patients with T2DM and OSA had significantly lower GLS, GCS, GAS, and GRS than the controls and the patients with T2DM alone (all p < .01). Fasting plasma glucose (FPG), OSA and BMI had negative impacts on all and part of the strain values in T2DM patients. The T2DM patients with moderate-to-severe OSA showed significantly lower GLS, GCS, GAS, and GRS than those with mild OSA (all p < .05).

Conclusions

The 3DSTE plus conventional echocardiography could detect the sub-clinical LV alterations in T2DM patients with or without OSA.

中文翻译：

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阻塞性睡眠呼吸暂停对2型糖尿病患者左心室重构和功能障碍的加重作用：3D斑点追踪超声心动图病例对照研究

摘要

目标

本研究的目的是使用 3D 斑点追踪超声心动图 (3DSTE) 评估伴或不伴阻塞性睡眠呼吸暂停 (OSA) 的 2 型糖尿病 (T2DM) 患者左心室 (LV) 结构和功能的早期改变。

方法

80 名 LVEF 保留的 T2DM 患者被纳入，其中一半患有 OSA 作为合并症。还招募了 40 名年龄和性别匹配的对照。通过常规超声心动图和 3DSTE 评估 LV 结构和功能。LV 全局纵向应变 (GLS)、全局周向应变 (GCS)、全局区域应变 (GAS) 和全局径向应变 (GRS) 均由 3DSTE 测量。

结果

四种几何图案（正常几何、同心重塑、同心和偏心肥大）在三组中所占比例显着不同 ( p  = .014)。LV 重塑在两个 T2DM 组中所占份额高于对照组，而 LV 肥大最常出现在 T2DM 和 OSA 患者中。单纯 T2DM 患者的 GLS 和 GCS 明显低于对照组（均p  < .01）。患有 T2DM 和 OSA 的患者的 GLS、GCS、GAS 和 GRS 显着低于对照组和仅患有 T2DM 的患者（所有p <.01). 空腹血糖 (FPG)、OSA 和 BMI 对 T2DM 患者的全部和部分应变值有负面影响。与轻度 OSA 患者相比，具有中度至重度 OSA 的 T2DM 患者的 GLS、GCS、GAS 和 GRS 显着降低（所有p  < .05）。

结论

3DSTE 加常规超声心动图可以检测伴或不伴 OSA 的 T2DM 患者的亚临床 LV 改变。