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Disturbed glucose metabolism is associated with left ventricular dysfunction using tissue Doppler imaging in patients with myocardial infarction
Authors:Henareh Loghman  Lind Britta  Brodin Lars-Ake  Agewall Stefan
Institution:Department of Cardiology, Karolinska University Hospital, Huddinge, Karolinska Institute, Stockholm, Sweden. loghman.herareh@karolinska.se
Abstract:AIMS: To investigate the association between glucose abnormalities and left ventricular (LV) function assessed by tissue Doppler imaging (TDI) in patients with previous history of myocardial infarction and without known diabetes mellitus. PATIENTS AND METHODS: In a cross-sectional study, 123 patients, aged 31-80 years, with a history of previous myocardial infarction and without known diabetes mellitus were examined with TDI echocardiography. A standard oral glucose test (OGTT) with 75 g of glucose was performed. RESULTS: Two-hour plasma glucose were significantly and negatively associated with TDI parameters such as LV ejection time; early diastolic filling velocity (E'-v); ratio of the early to late diastolic filling velocity (E'/A') and positively associated with regional myocardial performance index (MPI) (P<0.05). Left ventricular ejection time and MPI were significantly higher; E'/A' and E'-v were significantly lower in patients with disturbed glucose metabolism compared with patients with normal glucose tolerance (P<0.01). These differences remain significant also when the patients with DM were excluded. CONCLUSIONS: The present study demonstrates that disturbed glucose metabolism is associated with more pronounced LV dysfunction using TDI in patients with myocardial infarction. These abnormalities in LV function were more common not only in subjects with diabetes, but also in patients with prediabetic condition, impaired glucose intolerance.
Keywords:diabetes mellitus  left ventricular function  myocardial infarction  myocardial performance index  tissue Doppler imaging
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