Left ventricular pressure strain loops for evaluation on myocardial work in type 2 diabetic patients with or without hypertension

Purpose: To evaluate the myocardial work (MW) changes in type 2 diabetes mellitus (T2DM) patients with or without hypertension(HT) using left ventricular pressure strain loops（LVPSL）, and to find independent related factors of MW parameters. Methods: : 40 T2DM patients, 38 T2DM patients with HT and 35 controls were enrolled. The differences between clinical data, conventional ultrasound parameters and MW parameters were analyzed among the three groups. Results: : The global longitudinal strain (GLS) of T2DM group and T2DM+HT group was lower than controls ( P ＜0.05). The global work index (GWI) and global constructive work (GCW) in T2DM group were lower than other groups ( P ＜0.05). T2DM+HT group had higher global work waste (GWW) and lower global work efficiency (GWE) ( P ＜0.05). Systolic blood pressure (SBP), glycosylated hemoglobin (HbA1c), duration of D2DM and pulse pressure (PP) were independent related factors of GWI, while SBP, HbA1c, duration of T2DM and diastolic blood pressure (DBP) were GCW. SBP and HbA1c were independent factors of GWW, HbA1c and duration of HT were independent factors of GWE. Conclusion: LVPSL can recognize left ventricular subclinical systolic dysfunction early in patients with T2DM. SBP and HbA1c are two factors that have a considerable impact on MW parameters. GWE may be the best predictor of the left ventricular systolic function in the MW parameters. The impact of afterload on MW parameters should be paid more attention.