Early detection of left ventricular dysfunction in first-degree relatives of diabetic patients by myocardial deformation imaging: The role of endothelial glycocalyx damage
| Autor: | John Parissis, Filio Spanoudi, George Pavlidis, Eirini Maratou, Ignatios Ikonomidis, John Lekakis, F Kousathana, Maria Varoudi, Vaia Lambadiari, Helen Triantafyllidi, George Dimitriadis |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty endocrine system diseases Heart Ventricles Early detection 030209 endocrinology & metabolism Speckle tracking echocardiography 030204 cardiovascular system & hematology Glycocalyx Ventricular Function Left 03 medical and health sciences Ventricular Dysfunction Left 0302 clinical medicine Insulin resistance Diabetes mellitus Internal medicine medicine Humans Family First-degree relatives business.industry Myocardium nutritional and metabolic diseases medicine.disease Endothelial glycocalyx Endocrinology Postprandial Early Diagnosis Diabetes Mellitus Type 2 Echocardiography Cardiology Female Endothelium Vascular Insulin Resistance Cardiology and Cardiovascular Medicine business |
| Zdroj: | International journal of cardiology. 233 |
| ISSN: | 1874-1754 |
| Popis: | First-degree relatives of type-2 diabetes patients (FDR) present insulin resistance. We investigated whether FDR and dysglycaemic subjects demonstrate abnormal endothelial glycocalyx and LV deformation during postprandial hyperglycemia.We studied 40 FDR with normal oral glucose test (OGTT), 40 subjects with abnormal OGTT (dysglycaemic) and 20 subjects with normal OGTT without parental history of diabetes (normoglycaemic). At 0 and 120min of OGTT we measured: a) LV longitudinal strain (LS) of subendocardial, mid-myocardial and subepicardial layers, global LS (GLS), peak twisting (pTw), untwisting velocity (pUtwVel), by speckle tracking echocardiography b) perfused boundary region (PBR) of the sublingual arterial microvessels; high PBR values represent reduced glycocalyx thickness. Insulin resistance was evaluated using insulin sensitivity index (ISI).ISI was related with baseline PBR, GLS and pTw in all subjects (p0.05). Compared to normoglycaemics, FDR and dysglycaemics had higher PBR, lower ISI, GLS (-18.4±2.6 and -16.8±2.0 vs. -19.2±2.4%), subendocardial LS (-19.0±4.2 and -17.9±3.0 vs. -20.1±3.4%), pTw (14.4±4.4 and 15.6±6.4 vs. 16.9±6.5deg) and pUtwVel (p0.05 for all comparisons). A GLS-18% identified FDR with LV dysfunction (p=0.016). Post-OGTT, GLS and the subendocardial LS decreased while pTw and pUtwVel increased in FDR and dysglycaemics (p0.05) indicating prevalence of the motion of the subepicardial over a dysfunctioning subendocardial myocardial helix. Increased PBR was related with impaired deformation markers at baseline and 120min of OGTT (p0.05).First-degree relatives and dysglycaemics have reduced glycocalyx thickness related with impaired LV longitudinal, twisting-untwisting function. Postprandial hyperglycemia when combined with insulin resistance causes LV longitudinal dysfunction leading to increased LV twisting. |
| Databáze: | OpenAIRE |
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