Decreased Radial Function is Associated With Subtle Left Ventricular Remodeling in Type 2 Diabetes Mellitus

Background: Previous studies have suggested that reduced longitudinal myocardial function might be compensated by increased radial contractility in patients with type 2 diabetes mellitus (DM). Aim: To evaluate left ventricular (LV) remodeling in type 2 DM according to radial function assessed by STI. Methods: 234 asymptomatic type 2 DM patients with no sign or history of heart disease and normal conventional echo parameters were included. Mean radial strain (SR) was assessed by STI from short-axis view at the midventricular level. Mean longitudinal strain (SL) was calculated from the apical 2- and 4-chamber views. The population was divided into 3 groups according to SR value: group I = SR 60% (n = 57). Differences between groups were tested by ANOVA. Results: Clinical, biological and echographic data are shown in table. Age, body mass index (BMI), duration and severity of DM, systolic (sBP) and diastolic (dBP) blood pressure and LV mass index (LVMi) were similar between groups. Conventional systolic parameters (LVEF: LV ejection fraction and FS: fractional shortening) were also similar. However, a lower SR was associated with a significant increase in LV end-diastolic (LVEDD) and end-systolic (LVESD) diameters and a decreased SL. Conclusion: These data suggest that an altered radial function might be an indicator of more advanced diabetic cardiomyopathy with altered systolic function and beginning of eccentric LV remodelling