Echocardiographic evaluation of pulmonary vascular resistance in patients with type2 diabetes mellitus concerning diabetic duration and HbAlc level and its effect on the right ventricular function

Authors

  • Jabbar Sirhan Hassan Babylon Health Directorate, Ministry of Health, Babylon, Iraq.
  • Basim Shnain Jasim Babylon Health Directorate, Ministry of Health, Babylon, Iraq.
  • Aqeel Jassim Mehammed Babylon Health Directorate, Ministry of Health, Babylon, Iraq.

DOI:

https://doi.org/10.22317/imj.v5i1.996

Abstract

Objective: The study aims to non-invasive assessment of PVR by echocardiography in type 2 DM and its relation to duration of DM and HbAIc level and association of PVR to RV systolic and diastolic function.

Methods: This cross-sectional comparative and analytic study was conducted on 62 consisting of patients with type 2 diabetes mellitus without a history of hypertension, established coronary artery disease, and chronic obstructive pulmonary disease. All diabetic patients were studied for age, sex. BMI, HbAlc level, and duration of diabetes, and echocardiography was performed to assess PVR systolic (TAPSE.MPI) and diastolic (E/A, E/ē) function of RV.

Results: The study reveals there is no significant difference in PVR RV systolic and diastolic function concerning HbAIc level and DM duration. While there is significantly higher PVR and significantly lower TAPSE and E/A in DM (p<0.05) in comparison with normal control subjects. In correlation of PVR with systolic and diastolic function of RV, there were showed a strong negative relationship between PVR and systolic function and weak positive relationship with diastolic dysfunction P-value <0.05.

Conclusion: significant-high pulmonary vascular resistance in type 2 DM and inverse correlation to systolic function and linear correlation to diastolic dysfunction of the right ventricle, while there is no relation of PVR to Hb Alc level and duration DM.

References

1. de Simone G, Wang W, Best LG, Yeh F, Izzo R, Mancusi C, et al. Target organ damage and incident type 2 diabetes mellitus: The Strong Heart Study. Cardiovasc Diabetol. 2017;16(1):1–9.
2. Association AD. 14. Diabetes care in the hospital: standards of medical care in diabetes—2018. Diabetes Care. 2018;41(Supplement 1): S144–51.
3. Marcu R, Choi YJ, Xue J, Fortin CL, Wang Y, Nagao RJ, et al. Human organ-specific endothelial cell heterogeneity. IScience. 2018; 4:20–35.
4. Sanz J, Sánchez-Quintana D, Bossone E, Bogaard HJ, Naeije R. Anatomy, function, and dysfunction of the right ventricle: JACC state-of-the-art review. J Am Coll Cardiol. 2019;73(12):1463–82.
5. Naing P, Kuppusamy H, Scalia G, Hillis GS, Playford D. Non-invasive assessment of pulmonary vascular resistance in pulmonary hypertension: current knowledge and future direction. Heart Lung Circ. 2017;26(4):323–30.
6. Jørgensen PG, Jensen MT, Mogelvang R, von Scholten BJ, Bech J, Fritz-Hansen T, et al. Abnormal echocardiography in patients with type 2 diabetes and relation to symptoms and clinical characteristics. Diabetes Vasc Dis Res. 2016;13(5):321–30.
7. Hocaoglu-Emre FS, Saribal D, Yenmis G, Guvenen G. Vascular cell adhesion molecule 1, intercellular adhesion molecule 1, and cluster of differentiation 146 levels in patients with Type 2 diabetes with complications. Endocrinol Metab. 2017;32(1):99–105.
8. Mazurek JA, Vaidya A, Mathai SC, Roberts JD, Forfia PR. Follow-up tricuspid annular plane systolic excursion predicts survival in pulmonary arterial hypertension. Pulm Circ. 2017;7(2):361–71.
9. Browning JR. Effects of right ventricular diastolic dysfunction on coherent flow structures in the human right atrium and right ventricle. University of Colorado at Boulder; 2016.
10. Kang Y, Wang S, Huang J, Cai L, Keller BB. Right ventricular dysfunction and remodeling in diabetic cardiomyopathy. Am J Physiol Circ Physiol. 2019;316(1): H113–22.
11. Su W-Y, Chen S-C, Huang Y-T, Huang J-C, Wu P-Y, Hsu W-H, et al. Comparison of the effects of fasting glucose, hemoglobin a1c, and triglyceride–glucose index on cardiovascular events in type 2 diabetes mellitus. Nutrients. 2019;11(11):2838.

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Published

2021-03-26

How to Cite

Hassan, J. S., Jasim, B. S., & Mehammed, A. J. (2021). Echocardiographic evaluation of pulmonary vascular resistance in patients with type2 diabetes mellitus concerning diabetic duration and HbAlc level and its effect on the right ventricular function. Iraq Medical Journal, 5(1). https://doi.org/10.22317/imj.v5i1.996

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