Advanced Role of LV GLS to Access Cardiovascular Morbidity in Diabetic Cardiomyopathy Presenting Heart Failure.

Abstract

Background: Diabetes-associated changes in the structure and function of the myocardium leads to heart failure (HF) that is not directly attributable to other confounding factors such as coronary artery disease (CAD) or hypertension called diabetic cardiomyopathy (DbCMP). NT‐pro BNP is an excellent and easy-to-perform biomarker in HF but has limited ability to assess HF in patients with normal ejection fraction.

Objectives: To admittance the left ventricular global longitudinal strain in DbCMP with HF for justification to access cardiovascular adverse events.

Methods: Retrospective study between 2017 to 2020 followed by 12 months of observation for morbidity and mortality. We enrolled 370 cases of DbCMP patients and compared them with the control (n=350). We included adults, age 58+/- 16.5 years, with New York Heart Association (NYHA) class I through IV. Specially LV Global Longitudinal Strain (LVGLS) was assessed by velocity vector imaging using 2-, 3-, and 4-chamber views apart from routine LV diastolic function; IVRT, DT, E/A ratio, E/e’, LA Volume, LV Systolic function.

Results: We initiate considerable difference of left LVGLS in the DbCMP group -10.6 ± 4.3% as compared to the control group LVGLS was -18.7 ± 2.3%. Left ventricular ejection fraction (LVEF) was assessed in the case versus the control group (46±11% vs 59±6%). LV GLS <-9% was significantly associated with higher 12 months mortality and HF patients with DbCMP, not only in reduced LVEF but also in fair LVEF. 

Conclusions: LVGLS has a more significant value to assess heart failure and mortality among DbCMP.