Assessment of the subclinical myocardial dysfunction with preserved left ventricle ejection fraction in type 2 diabetes mellitus patients with global myocardial work

Abstract To assess the subclinical left ventricle(LV) myocardial dysfunction in preserved left ventricle ejection fraction(LVEF) in type 2 diabetes mellitus(T2DM) patients by global myocardial work(MW). 60 untreated T2DM patients and 60 normal controls were enrolled for this study. Apical 4-, 3- and 2- chamber views were acquired by two-dimensional echocardiography. Peak systolic myocardial layer-specific global longitudinal strain(GLS), peak strain dispersion(PSD), global myocardial work index(GWI), global constructive work(GCW), global wasted work(GWW), and myocardial work efficiency(GWE) were generated by speckle-tracking echocardiography(STE). The values of GLS in T2DM patients were significantly lower than normal controls(p < 0.05). GWW in T2DM patients was significantly larger than normal controls, while GWE was significantly lower(p < 0.05). In T2DM patients, fasting plasma glucose positively correlated with GWW, while negatively correlated with GWE, respectively. ROC analysis showed GWE was superior to other values with a highest AUC of 0.688. Logistic regression analysis indicated that GLSEndo (OR = 1.196, 95% CI: 1.012–1.414, p = 0.036), and GWE (OR = 0.585, 95% CI: 0.414–0.825, p = 0.002) were independent risk factors associated with LV function in T2DM patients. From the research, the subclinical LV myocardial dysfunction was detected by GLS and global MW in T2DM patients. Global MW is a sensitive predictor to demonstrate the subclinical LV myocardial dysfunction in T2DM patients.