Analysis of cardiac function changes and its influencing factors in elderly patients with type 2 diabetic nephropathy
Objective To investigate the early changes of cardiac function and related risk factors in elderly patients with type 2 diabetes mellitus(DM)by two-dimensional spot tracking strain echocardiography(2D-STE).Methods From March 2022 to March 2023,44 elderly patients with type 2 diabetic nephropathy(DN),56 DM patients and 20 elderly healthy controls were selected from Huadong Hospital Affiliated to Fudan University.Their clinical data were collected and routine ech-ocardiography and 2D-STE were performed.The index differences were compared among the three groups.Multivariate logistic regression was used to analyze the risk factors for subclinical left ventricular systolic dysfunction(GLS＜18%)in patients.Results The 2D-STE results showed that the E/e'value and the proportion of diastolic dysfunction(E/e'＞14)in the DN group were significantly higher than those in the healthy control group or the DM group.Compared with the healthy control group or DM group,the global longitudinal strain(GLS)value of left ventricle of the DN group decreased significantly,and the incidence of subclinical left ventricular systolic dysfunction increased significantly,with statistical significance.Logistic re-gression analysisshowed that albuminuria,eGFR＜60 mL/min/1.73 m2 and total cholesterol were risk factors for subclinical left ventricular systolic dysfunction in elderly DM patients.Conclusion Elderly DN patients have diastolic dysfunction and subclinical left ventricular systolic dysfunctionassessedby GLS.Albuminuria,GFR＜60 mL/min/1.73 m2 andtotalcholester-ol are closely related to left ventricular systolic longitudinal myocardial dysfunction in elderly DM patients.
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