Annals of vascular surgery · 2021
Detection of Early Ultrasonographic Markers of Cardiovascular Dysfunction in Prediabetes Patients.
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Sm Firmino, Kw Wende, Jp Gregorio, Fy Yuamoto, Ad Heubel, Ez Kabbach, Pb Santos, Cl Goulart, H Pott-Junior, A Borghi-Silva, Rg Mendes, Amo Leal, Mg Roscani
Аннотация
BACKGROUND: Prediabetes individuals may present incipient signals of cardiovascular injury and evaluate with unfavorable outcome. The aim of this study was to identify early ultrasonographic markers of cardiac dysfunction and arterial stiffness among glucose intolerant patients compared to healthy individuals.
METHODS: Cross-sectional study with the composition of two groups: Prediabetes (PD) who met the criteria for pre-diabetes and Normoglycemic (NG): presented no criteria of pre-diabetes and diabetes mellitus in all applied tests. Clinical evaluation, assessment of cardiac function by transthoracic echocardiogram, carotid intima-media thickness by carotid ultrasonographic and evaluation of arterial stiffness by SphygmoCor® device was performed.
RESULTS: Eighty adults were included in this study: PD (n = 43) and NG (n = 37). PD patients were more dyslipidemic and presented early alterations in echocardiographic variables, like: peak mitral velocity E (E (cm/sec): NG 84 ± 13 vs. PD 77 ± 11, P = 0.03), E/A Tricuspid inflow (NG: 1.5 ± 0.4 vs. PD 1.3 ± 0.3, P = 0.03), Tricuspid tissue Doppler E' (E'tric (cm/sec): NG 15.2 ± 4.4 vs. PD 13.4 ± 3.2, P = 0.04) and increased arterial stiffness (Pulse Wave Velocity: PWV (m/s): NG 7.2 ± 1.5 vs. PD 7.9 ± 1.7, P = 0.03). In the regression analysis, having an impaired oral glucose test was shown to be independently associated with reduced E Mitral, even after adjusting for a set of confounding factors.
CONCLUSIONS: PD patients showed early signals of an impaired cardiac function and an increased pulse wave velocity when compared with healthy individuals. These results point to treatment optimization strategies, especially when considering preventive measures for cardiovascular outcomes, like diabetic cardiomyopathy.
METHODS: Cross-sectional study with the composition of two groups: Prediabetes (PD) who met the criteria for pre-diabetes and Normoglycemic (NG): presented no criteria of pre-diabetes and diabetes mellitus in all applied tests. Clinical evaluation, assessment of cardiac function by transthoracic echocardiogram, carotid intima-media thickness by carotid ultrasonographic and evaluation of arterial stiffness by SphygmoCor® device was performed.
RESULTS: Eighty adults were included in this study: PD (n = 43) and NG (n = 37). PD patients were more dyslipidemic and presented early alterations in echocardiographic variables, like: peak mitral velocity E (E (cm/sec): NG 84 ± 13 vs. PD 77 ± 11, P = 0.03), E/A Tricuspid inflow (NG: 1.5 ± 0.4 vs. PD 1.3 ± 0.3, P = 0.03), Tricuspid tissue Doppler E' (E'tric (cm/sec): NG 15.2 ± 4.4 vs. PD 13.4 ± 3.2, P = 0.04) and increased arterial stiffness (Pulse Wave Velocity: PWV (m/s): NG 7.2 ± 1.5 vs. PD 7.9 ± 1.7, P = 0.03). In the regression analysis, having an impaired oral glucose test was shown to be independently associated with reduced E Mitral, even after adjusting for a set of confounding factors.
CONCLUSIONS: PD patients showed early signals of an impaired cardiac function and an increased pulse wave velocity when compared with healthy individuals. These results point to treatment optimization strategies, especially when considering preventive measures for cardiovascular outcomes, like diabetic cardiomyopathy.