Evaluation of the frequency of left ventricular dyssynchrony and its predictors by tissue Doppler echocardiography in asymptomatic diabetic patients without cardiovascular disease

Diabetes mellitus is a common chronic disease in the world, independently associated with an increased risk of cardiovascular disease (CVD) and heart failure (HF). Patients with diabetes have worse outcomes once heart disease developes; thus, the timely detection of diabetic heart disease is necessary to prevent the progression of CVD and HF. Also, Left ventricular (LV) dyssynchrony is used to detect the evidence of pre-clinical cardiac dysfunction. The purpose of the current investigation was to assess factors that influence LV dyssynchrony in patients with type 2 diabetes mellitus without evidence of concomitant CVD.

In the current descriptive study, 100 patients with type 2 diabetes and without symptoms of heart disease were included. Finally, the data of 52 patients who did not meet any of the exclusion criteria were analyzed. Parameters of sex, age, blood pressure, smoking, duration of diabetes, glycosylated hemoglobin (HB-A1C), and parameters of LV dyssynchrony were analyzed using tissue doppler echocardiography (TDI). Patients were divided into two subgroups based on the presence or absence of LV dyssynchrony and these two subgroups were compared in terms of the mentioned parameters.

The mean age of the patients was 8.8 ± 53.2 years and 30 patients (%57) were male. LV dyssynchrony was present based on the septal to lateral Ts delay index as well as total asynchrony index in %35 of the patients and based on the septal to posterior wall motion delay in %25 of them. Glycosylated hemoglobin levels were significantly different between the two groups with and without LV dyssynchrony (p˂0.001). 

It seems that in patients with asymptomatic type 2 diabetes and without concomitant cardiovascular disease, LV dyssynchrony, which is the early marker of subclinical cardiac dysfunction,has a significant frequency and has a significant relationship with glycosylated hemoglobin levels.