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Diabetes as an independent predictor of left ventricular longitudinal strain reduction at rest and during dobutamine stress test in patients with significant coronary artery disease.

Session Poster session 1

Speaker Dawid Miskowiec

Event : ESC Congress 2017

  • Topic : coronary artery disease, acute coronary syndromes, acute cardiac care
  • Sub-topic : Coronary Artery Disease (Chronic)
  • Session type : Poster Session

Authors : K Wierzbowska-Drabik (Lodz,PL), P Hamala (Lodz,PL), M Simiera (Lodz,PL), D Miskowiec (Lodz,PL), JD Kasprzak (Lodz,PL)

Authors:
K. Wierzbowska-Drabik1 , P. Hamala1 , M. Simiera1 , D. Miskowiec1 , J.D. Kasprzak1 , 1Medical University - Lodz - Poland ,

Citation:
European Heart Journal ( 2017 ) 38 ( Supplement ), 199

Introduction: Diabetes (DM) is a strong cardiovascular risk factor modifying left ventricular (LV) function which may be objectively assessed with echocardiographic strain analysis. Whereas the impact of isolated DM on myocardial deformation has been already studied, few data concern diabetics with coronary artery disease (CAD) especially in all stages of dobutamine stress echocardiography (DSE).

Aim: We compared LV systolic function during DSE in CAD with and without DM using state-of-the art speckle-tracking quantification and assessed the impact of DM on LV systolic strain.

Methods: DSE was performed in 250 patients with angina who afterwards had coronarography with ≥50% stenosis in left main and ≥70% in other arteries considered as significant. We included 127 patients with CAD: 42 with DM (DM+; mean age 64±9), and age- and sex-matched 85 patients without DM (DM-; mean age 63±9). The severity of CAD and LV ejection fraction were similar in both groups.

Results: Global and regional LV peak systolic longitudinal strain (PSLS) revealed in all DSE phases lower values in DM+ group: 14.5±3.6% vs 17.4±4.0% at rest, p=0.0001, 13.8±3.9% vs 16.7±4.0% at peak stress, p=0.0002 and 14.2±3.1% vs 15.5±3.5% at recovery, p=0.0432 for global parameters. LV ejection fraction, body surface area and diabetes were independent predictors for systolic LV strain in model including 16 variables (R2=0,51, p<0.001).

Conclusions: Systolic strain although impaired in both group with CAD was lower in diabetics in all stages of DSE. Moreover, DM was confirmed as independent predictor of systolic function reduction in CAD.

Comparison between DM+ and DM&#x2212; group
ParameterDM+DM−p value
Sex12F/30M25F/60Mns
Body mass [kg]87.7±16.680.0±14.8=0.0091
Body mass index [kg/m2]30.7±5.728±3.9=0.0022
Waist circumference [cm]103.4±15.896.1±14.2=0.0097
Heart rate at baseline [beats per minute]65±767±10ns
Hypertension [number; %]41 (98%)79 (93%)ns
Smoking [number; %]32 (76%)52 (61%)ns
Hypercholesterolemia [number; %]42 (100%)76 (89%)ns
AFI global PSLS at baseline [%]14.5±3.617.4±4.0=0.0001
AFI global PSLS at peak [%]13.8±3.916.7±4.0=0.0002
AFI global PSLS at recovery [%]14.2±3.115.5±3.5=0.0432
DM, diabetes mellitus; F, females; M, males; AFI, automated function imaging; PSLS, peak systolic longitudinal strain.

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