Evaluation of left ventricular systolic function in patients with type 2 diabetes mellitus with different body mass index by two-dimensional layer-specific speckle tracking Imaging
Evaluation of left ventricular systolic function in patients with type 2 diabetes mellitus with different body mass index by two-dimensional layer-specific speckle tracking Imaging
肖骏 1杨梅 1杨芳 2刘娴1
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作者信息
1. 405499 重庆市开州区人民医院超声科
2. 川北医学院附属医院超声科
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摘要
目的:应用二维斑点追踪(two-dimensional speckle tracking imaging,2D-STI)分层应变技术评价不同BMI的2型糖尿病(type2diabetesmellitus,T2DM)患者左心室纵向分层应变,以了解不同BMI对T2DM患者左心室收缩功能的影响.方法:入选2021年1月至2023年3月,就诊于开州区人民医院,初次诊断为T2DM的患者102例,根据不同BMI分为三组,正常体质量组(18.5kg/m2≤BMI ≤ 24 kg/m2),超质量组(24 kg/m2＜BMI＜28 kg/m2)肥胖组(BMI ≥ 28 kg/m2).所有患者均连接心电模拟信号,采集常规超声心动图二维参数同时应用2D-STI分层应变技术获得左心室整体纵向收缩峰值应变(global longitudinal strain,GLS)、左室心内膜下纵向应变(longitudinal peak strain of subendocardial myocardial,LPSEndo)、中层纵向应变(longitudinal peak strain of middle myocardia,LPSMid)及心外膜下心肌纵向应变(longitudinal peak strain of subepicardial myocardial,LPSEpi).比较各组超声心动图常规二维参数及应变间的差异.结果:从正常体质量组、超质量组到肥胖组GLS、LPSEndo、LPSMid、LPSEpi 的绝对值逐渐减低(F=20.574、60.375、5.964、20.383,P＜0.05),差异有统计学意义(P＜0.05).与正常体质量组相比,超质量组GLS、LPSEndo、LPSMid、LPSEpi的绝对值减低,差异有统计学意义(P＜0.05).与超质量组相比,肥胖组GLS、LPSEndo、LPSMid、LPSEpi的绝对值减低,差异有统计学意义(P＜0.05).ROC曲线显示LPSEndo诊断左心室收缩障碍的曲线下面积(AUC=91.2％,95％CI:0.840～0.959),最佳诊断界值为-21.9％,敏感度为66.7％,特异度为100％(P＜0.05).结论:2D-STI分层应变技术可定量分析不同BMI对T2DM患者左心室收缩功能的影响,为临床诊断及治疗提供质量要依据.
Abstract
Objective:In this study we use two-dimensional layer-specific speckle tracking Imaging to evaluate the longitudinal layered strain of type 2 diabetes mellitus(T2DM)with different BMI,in order to understand its affection on left ventricular systolic function.Methods:A total of 102 patients first diagnosed with T2DM were enrolled and The People's Hospital of kaizhou District from January 2021 to March 2023.They were divided into three groups according to different BMI.30 patients with the 18.5 kg/m2≤BMI≤24kg/m2 were normal weight group;38 patients with the 24kg/m2＜BMI＜28kg/m2 were overweight group.There were 34 patients with BMI ≥ 28kg/m2 were obese group.All patients were connected to ECG analog signals,conventional 2D echocardiographic parameters were collected.Meanwhile,two-dimensional layer-specific speckle tracking Imaging were used to obtain the global longitudinal strain(GLS),longitudinal peak strain of subendocardial myocardial(LPSEndo),longitudinal peak strain of middle myocardial(LPSMid),longitudinal peak strain of subepicardial myocardial(LPSEpi).To compare the differences of conventional two-dimensional echocardiographic parameters and strain between groups in each group.Results:The absolute values of GLS,LPSEndo,LPSMid,and LPSEpi gradually decreased from normal weight,overweight to obese group(F=20.574,60.375,5.964,20.383,P＜0.05),and the difference was statistically significant(P＜0.05).Compared with the normal weight group,the absolute values of GLS,LPSEndo,LPSMid and LPSEpi in the overweight group were decreased,and the difference was statistically significant(P＜0.05).Compared with the overweight group,the absolute values of GLS,LPSEndo,LPSMid,and LPSEpi in the obese group decreased,and the difference was statistically significant(P＜0.05).The ROC curve showed that the area under the curve(AUC)and(95％CI)of LPSEndo for diagnosing left ventricular systolic dysfunction was 91.2％,95％CI was(0.840-0.959),the best diagnostic cutoff was-21.2％,and the sensitivity was 66.7％,the specificity was 100％(P＜0.05).Conclusions:The two-dimensional layer-specific speckle tracking imaging can quantitatively analyze the affection of different BMI on left ventricular systolic function in patients with T2DM.
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