부산대학교 도서관

Background and Aim:Two-dimensional (2D) speckle tracking echocardiography (STE) has shown promising results being a recent technology to assess “myocardial performance” in cardiac patients. Three-dimensional echocardiography 3DE has been shown to be accurate in the assessment of left ventricular (LV) systolic function. The multigated acquisition (MUGA) scan provides a more accurate quantification of the ventricular ejection fraction To Assess the role of 2D-STE and 3DE in the assessment of LV systolic function in type II patients with diabetes with negative myocardial perfusion imaging in correlation with the MUGA scan.Materials and Methods:The study included 30 patients with type 2 diabetes mellitus (T2DM) [Group 1, 25 (83%) female and 5 (16%) males with mean age 48.40 ± 7.44], their stress myocardial perfusion imaging was negative for coronary ischemia. The control group included 15 apparently healthy age and sex-matched subjects, [Group 2, 11 (73%) females and 4 (26%) males with mean age 50.20 ± 7.74], LV systolic function was evaluated using conventional, TDI, 2D-STE (LV-GLS), 3-DE and MUGA scan.Results:The group with diabetes showed statistically highly significant reduction in LV-GLS (-18.07 ± 2.73 in group 1 vs -21.24 ± 1.29 in group 2, P < 0.001), and in 3D LVEF (52.30 ± 5.28 in Group 1 vs 58.93 ± 4.69 in Group 2, P < 0.001). We found an agreement between three modalities (speckle tracking, 3DE and MUGA scan) by 33% in 10 patients [3 patients (10%) had impaired LV functions and 7 patients (23%) had preserved LV functions]. There was an agreement between speckle tracking and 3D echo by 76.6% in 23 patients [16 patients (53.3%) had impaired LV functions and 7 patients (23.3%) had preserved LV functions].Conclusion:T2DM is associated with subclinical LV systolic dysfunction that can be assessed by different noninvasive modalities (speckle tracking, 3DE and the MUGA scan). 2D speckle tracking and 3DE might have an edge compared with MUGA scan in the detection of subclinical LV systolic dysfunction.