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Cardiovascular Diabetology
Published in: Cardiovascular Diabetology 1/2015

Open Access 01-12-2015 | Original investigation

Altered myocardial response in patients with diabetic retinopathy: an exercise echocardiography study

Authors: Zhe Zhen, Yan Chen, Kendrick Shih, Ju-Hua Liu, Michele Yuen, David Sai-Hung Wong, Karen Siu-Ling Lam, Hung-Fat Tse, Kai-Hang Yiu

Published in: Cardiovascular Diabetology | Issue 1/2015

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Abstract

Background

Type 2 diabetes mellitus (T2DM) complicated by retinopathy is associated with altered left ventricular (LV) structure and resting myocardial dysfunction unlike T2DM without retinopathy. The myocardial response to stress has not been compared in patients with and without diabetic retinopathy. The aim of this retrospective study was to determine the relationship between retinopathy and myocardial function in patients with T2DM at rest and during exercise echocardiography.

Methods

134 patients with T2DM and no evidence of underlying coronary artery disease were recruited. All patients underwent retinal photography to screen for diabetic retinopathy, and resting and exercise echocardiography. Resting echocardiography was analyzed by conventional echocardiographic parameters and speckle tracking derived global longitudinal strain (GLS). Exercise echocardiography parameters included diastolic function reserve index (DFRI) and stress GLS.

Results

The mean age of participants was 60 years and 49 % were male. Diabetic retinopathy was identified in 43 patients (32 %). Resting echocardiography revealed that those with diabetic retinopathy had a higher prevalence of impaired diastolic function, higher E/E′ ratio (LV filling pressures) and impaired resting GLS compared with those without. Exercise echocardiography revealed that those with diabetic retinopathy also had more impaired DFRI and stress GLS. Multivariable analysis showed that the presence of diabetic retinopathy was independently associated with high resting E/E′, diastolic dysfunction grade, impaired resting GLS, low DFRI and impaired stress GLS.

Conclusions

In conclusion, the presence of diabetic retinopathy was independently associated with impaired resting myocardial function (diastolic and systolic function) and myocardial function during stress (evaluated by DFRI and stress GLS).
Appendix
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Metadata
Title
Altered myocardial response in patients with diabetic retinopathy: an exercise echocardiography study
Authors
Zhe Zhen
Yan Chen
Kendrick Shih
Ju-Hua Liu
Michele Yuen
David Sai-Hung Wong
Karen Siu-Ling Lam
Hung-Fat Tse
Kai-Hang Yiu
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Cardiovascular Diabetology / Issue 1/2015
Electronic ISSN: 1475-2840
DOI
https://doi.org/10.1186/s12933-015-0281-5

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