الفهرس 
Assessment of Left ventricular strain in the pre-diabetic patients using two-dimensional speckle tracking Echocardiography
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Abstract
Ahmed A. Metwally, Heba M. Youssef, Naglaa M. Elsayed, Heba M. Eldeeb .
Introduction: Prediabetes is now a commonly accepted term for those whose glucose levels are below the cut-offs for a diabetes diagnosis but are higher than what is considered ’normal’. Individuals with prediabetes are at a significant risk of acquiring type 2 diabetes and its consequences. Measures of atherosclerotic load were considerably greater in prediabetic patients presenting with acute coronary syndrome than in non-diabetic individuals; this burden was comparable to that of diabetic patients.
Aim of work: to assess the left ventricular function among prediabetics compared to matched healthy control group using 2D echocardiography, speckled tracking echocardiography and tissue doppler imaging.
Subjects and methods: We conducted a prospective case control study enrolled
90 subjects, the included subjects were divided into two groups, group 1: prediabetic patients, group 2 matched health control. This study was conducted in Kasr Al-Ainy hospitals from September 2020 to March 2022. Subjects had a mean age 34.0 ±10.5 years, BMI 32.3 ±3.7 kg/m2.
Results: Our results showed Systolic dysfunction in pre-diabetic patients which is evident by significant lower fraction shortening (FS) [P value 0.006], significant lower Ejection fraction (EF) [P value 0.021] by standard echocardiography and significant lower lateral S wave [P value 0.0001] by Tissue doppler imaging (TDI), significant lower Global longitudinal strain (GLS) [ P value 0.0001] by speckled tracking echocardiography when compared to control group. Our results also revealed left ventricular diastolic dysfunction in pre-
diabetic patients which is evident by Grade I to II diastolic dysfunction in 24.4% of pre diabetic patients by standard echocardiography
The tissue doppler imaging (TDI) among prediabetics also revealed Significant higher E /e ratio [P value 0.006] which indicated high left ventricular filling pressure, significant prolonged Deceleration time (DT) [ P value 0.007], significant lower lateral E wave [P value 0.007], significant lower septal E wave [ P value 0.001] which indicated Grade I diastolic dysfunction, significant higher lateral A wave [P value 0.002] which indicated increased atrial contractility to compensate high left ventricular filling pressure, Significant lower medial E/A ratio [P value 0.024] when compared to control group.
Conclusion: Global longitudinal strain (GLS) is significantly impaired among prediabetics. Left ventricle diastolic dysfunction was more prevalent among prediabetics, So the condition of pre-diabetes is associated with impairment of both Systolic and diastolic functions of the left ventricle