Endocrine Abstracts (2012) 29 P619

Cardiac dyssynchrony as a pathophysiological mechanism of heart failure development and progression in type 2 diabetic patients

D. Lopin1, N. Lopina2, J. Rodionova1, M. Vlasenco1 & D. Volkov3

1Kharkov Medical Academy of Postgraduate Education, Kharkov, Ukraine; 2Kharkov National Medical University, Kharkov, Ukraine; 3Institute of General and Urgent Surgery of NAMS of Ukraine, Kharkov, Ukraine.

Objectives: Diabetes mellitus (DM) is an independent predictor of new onset heart failure (HF) and adverse outcomes among patients with already existing HF. However mechanisms leading to impaired cardiac performance due to DM are still unclear.

The purpose of investigation was to assess the influence of cardiac dyssynchrony (DYS) on systolic and diastolic function in patient with type 2 diabetes mellitus (T2DM) with concomitant stable coronary artery disease (CAD) and without arterial hypertension (AH).

Methods: In total, 42 patients (67±12 years, 20 males) with stable CAD, without AH in HF II–III NYHA class were divided into two age-matched groups: 1st group (n=22) – patients with T2DM (average duration 5.6±2.1 years) and 2nd group (n=20) – patients without DM. In all patients were determined body mass index (BMI), HbA1c level, HOMA-IR and specific echocardiographic tissue Doppler imaging (TDI) parameters as myocardial mitral annular (Sa) and basal segmental (Sm) systolic and early diastolic (Ea and Em) velocities, transmitral to TDI Ea ratio (E/Ea) and time to peak and onset of Sm from four basal and four mid left ventricular (LV) segments. Maximal difference in time between Sm-Ts-diff>90 ms and standard deviation-Ts-SD>37 ms were considered DYS.

Results: In the 1st group DYS and diastolic dysfunction were significantly more frequent than in the 2nd one (45.5 vs 35.0% and 68.2 vs 60.0% respectively, both P<0.05). Subanalysis of 1st group has shown correlation between Ts-SD and HbA1c level (r=+0.48, P<0.05), BMI (r=+0.51, P<0.05) and HOMA-IR (r=+0.57, P=0.048). The highest values of Ts-SD and Ts-diff were obtained in patients with Ea=2.2 m/s and E/Ea=42.

Conclusions: It was found that in patients with T2DM DYS is one of the factors which have negative impact on cardiac performance and thus the prognosis. The degree of mentioned disturbances correlates with glycemic control and insulin resistance.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.

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