Impact of overweight on left ventricular function in type 2 diabetes mellitus

• Published in: Cardiovascular diabetology Vol. 16; no. 1; p. 145
• Main Authors: Suto, Makiko, Tanaka, Hidekazu, Mochizuki, Yasuhide, Mukai, Jun, Takada, Hiroki, Soga, Fumitaka, Dokuni, Kumiko, Hatani, Yutaka, Hatazawa, Keiko, Matsuzoe, Hiroki, Sano, Hiroyuki, Shimoura, Hiroyuki, Ooka, Junichi, Matsumoto, Kensuke, Hirota, Yushi, Ogawa, Wataru, Hirata, Ken-Ichi
• Format: Journal Article
• Language: English
• Published: England BioMed Central 09-11-2017; BMC
• Subjects: Body mass; Body mass index; Body weight; Cardiovascular disease; Coexistence; Coronary artery; Coronary artery disease; Coronary vessels; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Heart diseases; Heart failure; Hypertension; Left ventricular diastolic function; Left ventricular longitudinal function; Multiple regression analysis; Obesity; Original Investigation; Overweight; Ventricle; Weight control; Left ventricular diastolic function; Left ventricular longitudinal function; Obesity; Diabetes mellitus
• ISSN: 1475-2840; 1475-2840
• DOI: 10.1186/s12933-017-0632-5

Coexistence of left ventricular (LV) longitudinal myocardial systolic dysfunction with LV diastolic dysfunction could lead to heart failure with preserved ejection fraction (HFpEF). Diabetes mellitus (DM) is known as a significant factor associated with HFpEF. Although the mechanisms of DM-related LV myocardial injury are complex, it has been postulated that overweight contributes to the development of LV myocardial injury in type 2 diabetes mellitus (T2DM) patients. However, the precise impact of overweight on LV longitudinal myocardial systolic function in T2DM patients remains unclear.
We studied 145 asymptomatic T2DM patients with preserved LV ejection fraction (LVEF) without coronary artery disease. LV longitudinal myocardial systolic function was assessed by global longitudinal strain (GLS), which was defined as the average peak strain of 18-segments obtained from standard apical views. Overweight was defined as body mass index (BMI) ≥ 25 kg/m
. Ninety age-, gender- and LVEF-matched healthy volunteers served as controls.
GLS of overweight T2DM patients was significantly lower than that of non-overweight patients (17.9 ± 2.4% vs. 18.9 ± 2.6%, p < 0.05), whereas GLS of both overweight and non-overweight controls was similar (19.8 ± 1.3% vs. 20.4 ± 2.1%, p = 0.38). Furthermore, multiple regression analysis revealed that for T2DM patients, BMI was the independent determinant parameters for GLS as well as LV mass index.
Overweight has a greater effect on LV longitudinal myocardial systolic function in T2DM patients than on that in non-DM healthy subjects. Our finding further suggests that the strict control of overweight in T2DM patients may be associated with prevention of the development of HFpEF.