Multilayer global longitudinal strain assessment of subclinical myocardial dysfunction related to insulin resistance
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ORIGINAL PAPER
Multilayer global longitudinal strain assessment of subclinical myocardial dysfunction related to insulin resistance Adem Atici1 · Ramazan Asoglu2 · Hasan Ali Barman3 · Remzi Sarikaya4 · Yucel Arman3 · Tufan Tukek4 Received: 22 July 2020 / Accepted: 18 September 2020 © Springer Nature B.V. 2020
Abstract Myocardial tissue is sensitive to insulin resistance (IR) due to its interactions with insulin levels. Previous studies demonstrated that heart failure prevalence was higher in IR patients. Evaluation of myocardial deformation by multilayer global longitudinal strain (MGLS) might provide more information about IR related left ventricular dysfunction. In this study, we aimed to investigate subclinical LV dysfunction with MGLS in patients with IR. The study was designed as a prospective cross-sectional study. The present study included 64 patients with IR (+), and 54 subjects without IR (−) prospectively. The homeostasis model of insulin resistance (HOMA-IR) was used to quantify insulin resistance. Specific analysis for endocardial, mid-myocardial and epicardial layers were performed by two-dimensional (2D) speckle tracking echocardiography (STE) for multilayer global longitudinal strain. MGLS (Endocard-Mid-myocard-Epicard) values were significantly lower in the IR (+) group compared to IR (−) group ((GLS-endocard; − 15.1 ± 1.5 vs. − 18.7 ± 1.3, p 150 mg/dL or use of antilipidemic drugs. Smoking status was classified as a current smoker or non-smoker. ECG and echocardiography data
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The International Journal of Cardiovascular Imaging
were assessed by two experienced cardiologists blinded to patient clinical information. ST-segment depression was defined as a > 1 mm downward displacement of the ST-segment in more than two contiguous leads. All participants provided written informed consent before the study. The study was approved by our Institutional Ethics Committee in accordance with the Declaration of Helsinki.
Echocardiographic assessment and strain imaging Conventional echocardiography using a Philips EPiq 7C system (Philips Healthcare Inc., Andover, MA, USA) and multilayer longitudinal strain imaging were performed by two experienced cardiologists. Echocardiographic images were obtained in the parasternal long-axis and short-axis and apical two-chamber and four-chamber views using standard transducer positions. Conventional echocardiographic parameters were measured according to the guidelines of the American Society of Echocardiography [15]. LV mass was calculated using the Devereux formula [16]. All examinations were videotaped and concurrent ECG traces were recorded. The LV end-diastolic (LVED) and end-systolic (LVES) diameters and interventricular septal and posterior wall thicknesses were expressed in millimeters in the parasternal long-axis view. LV end-systolic (LVES) and enddiastolic (LVED) volumes were measured from the apical four-chamber view. LVEF was calculated using the modified Simpson biplane method. LV filling pressure was measured using the pulsed-wave Doppler technique fr
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