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Cardiovascular Diabetology
Published in: Cardiovascular Diabetology 1/2013

Open Access 01-12-2013 | Original investigation

New concept of myocardial longitudinal strain reserve assessed by a dipyridamole infusion using 2D-strain echocardiography: the impact of diabetes and age, and the prognostic value

Authors: Thomas Cognet, Paul-Louis Vervueren, Laurent Dercle, Delphine Bastié, Rainui Richaud, Matthieu Berry, Pauline Marchal, Matthieu Gautier, Audrey Fouilloux, Michel Galinier, Didier Carrié, Pierre Massabuau, Isabelle Berry, Olivier Lairez

Published in: Cardiovascular Diabetology | Issue 1/2013

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Abstract

Aims

Although dipyridamole is a widely used pharmacological stress agent, the direct effects on myocardium are not entirely known. Diabetic cardiomyopathy can be investigated by 2D-strain echocardiography. The aim of this study was to assess myocardial functional reserve after dipyridamole infusion using speckle-tracking echocardiography.

Methods

Seventy-five patients referred for dipyridamole stress myocardial perfusion gated SPECT (MPGS) were examined by echocardiography to assess a new concept of longitudinal strain reserve (LSR) and longitudinal strain rate reserve (LSRR) respectively defined by the differences of global longitudinal strain (GLS) and longitudinal strain rate between peak stress after dipyridamole and rest. Twelve patients with myocardial ischemia were excluded on the basis of MPGS as gold standard.

Results

Mean LSR was −2.28±2.19% and was more important in the 28 (44%) diabetic patients (−3.27±1.93%; p = 0.001). After multivariate analyses, only diabetes improved LSR (p = 0.011) after dipyridamole infusion and was not associated with glycaemic control (p = 0.21), insulin therapy (p = 0.46) or duration of the disease (p = 0.80). Conversely, age (p = 0.002) remained associated with a decrease in LSR. LSSR was also correlated to age (p = 0.005). Patients with a LSR < 0% have a better survival after 15 months (log-rank p = 0.0012).

Conclusion

LSR explored by 2D speckle-tracking echocardiography after dipyridamole infusion is a simple and new concept that provides new insights into the impact of diabetes and age on the myocardium with a potential prognostic value.
Appendix
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Metadata
Title
New concept of myocardial longitudinal strain reserve assessed by a dipyridamole infusion using 2D-strain echocardiography: the impact of diabetes and age, and the prognostic value
Authors
Thomas Cognet
Paul-Louis Vervueren
Laurent Dercle
Delphine Bastié
Rainui Richaud
Matthieu Berry
Pauline Marchal
Matthieu Gautier
Audrey Fouilloux
Michel Galinier
Didier Carrié
Pierre Massabuau
Isabelle Berry
Olivier Lairez
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Cardiovascular Diabetology / Issue 1/2013
Electronic ISSN: 1475-2840
DOI
https://doi.org/10.1186/1475-2840-12-84

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