PMID- 26842466 OWN - NLM STAT- MEDLINE DCOM- 20161011 LR - 20221207 IS - 1475-2840 (Electronic) IS - 1475-2840 (Linking) VI - 15 DP - 2016 Feb 3 TI - Incremental prognostic value of global longitudinal strain in patients with type 2 diabetes mellitus. PG - 22 LID - 10.1186/s12933-016-0333-5 [doi] LID - 22 AB - BACKGROUND: Patients with type 2 diabetes mellitus (T2DM) are at high risk for cardiovascular events. The aim of the study was to assess whether global longitudinal strain (GLS) provides prognostic value in these patients. METHODS: A total of 247 T2DM patients without history of cardiovascular complications and participated in the CDATS study were prospectively enrolled. Left ventricular (LV) systolic function was assessed by LV ejection fraction and speckle tracking derived LV systolic GLS. Diastolic function was assessed by E/E' ratio defined as the passive trans-mitral LV inflow velocity to tissue Doppler imaging velocity of the medial mitral annulus. Cardiovascular event included acute coronary syndrome, cerebrovascular stroke, hospitalization for heart failure and cardiovascular death. RESULTS: A total of 18 cardiovascular events occurred during a median follow-up duration of 33 months. Both E/E' ratio [hazard ratio (HR) 1.15, P < 0.01] and GLS (HR 1.39, P < 0.01) were independently associated with cardiovascular events. Importantly, GLS provided incremental prognostic information in addition to clinical data, HbA1c and E/E' ratio (Chi square 77.46, P = 0.04). Receiver-operator characteristic curve analysis demonstrated that E/E' ratio [area under curve (AUC) 0.66, P = 0.03] and GLS (AUC 0.72, P < 0.01) were strong predictors of cardiovascular events. Kaplan-Meier analysis showed that patients with E/E' > 13.6 or GLS > -17.9 % were associated with cardiovascular events. The presence of either a high E/E' ratio or an impaired GLS provides an excellent negative predictive value of cardiovascular events in these patients. CONCLUSIONS: In T2DM patients with no history of cardiovascular disease, impaired GLS was associated with cardiovascular events and provided incremental prognostic value. FAU - Liu, Ju-Hua AU - Liu JH AD - Division of Cardiology, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Rm 1929b, Block K, Hong Kong, China. juhualiu1984@163.com. AD - Department of Medicine, Meishan People's Hospital, Meishan, Sichuan, China. juhualiu1984@163.com. FAU - Chen, Yan AU - Chen Y AD - Division of Cardiology, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Rm 1929b, Block K, Hong Kong, China. 2228057623@qq.com. FAU - Yuen, Michele AU - Yuen M AD - Division of Endocrinology, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China. 290505880@qq.com. FAU - Zhen, Zhe AU - Zhen Z AD - Division of Cardiology, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Rm 1929b, Block K, Hong Kong, China. zhenzhe717@gmail.com. FAU - Chan, Carmen Wing-Sze AU - Chan CW AD - Division of Cardiology, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Rm 1929b, Block K, Hong Kong, China. 250937741@qq.com. FAU - Lam, Karen Siu-Ling AU - Lam KS AD - Division of Endocrinology, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China. 289991830@qq.com. AD - Research Centre of Heart, Brain, Hormone and Healthy Aging, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong, China. 289991830@qq.com. FAU - Tse, Hung-Fat AU - Tse HF AD - Division of Cardiology, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Rm 1929b, Block K, Hong Kong, China. hftse@hkucc.hku.hk. AD - Research Centre of Heart, Brain, Hormone and Healthy Aging, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong, China. hftse@hkucc.hku.hk. AD - Division of Cardiology, Department of Medicine, the University of Hong Kong Shenzhen Hospital, Hong Kong, China. hftse@hkucc.hku.hk. FAU - Yiu, Kai-Hang AU - Yiu KH AD - Division of Cardiology, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Rm 1929b, Block K, Hong Kong, China. khkyiu@hku.hk. AD - Research Centre of Heart, Brain, Hormone and Healthy Aging, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong, China. khkyiu@hku.hk. AD - Division of Cardiology, Department of Medicine, the University of Hong Kong Shenzhen Hospital, Hong Kong, China. khkyiu@hku.hk. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20160203 PL - England TA - Cardiovasc Diabetol JT - Cardiovascular diabetology JID - 101147637 RN - 0 (Biomarkers) RN - 0 (Glycated Hemoglobin A) RN - 0 (hemoglobin A1c protein, human) SB - IM MH - Aged MH - Area Under Curve MH - Biomarkers/blood MH - Diabetes Mellitus, Type 2/blood/*complications/diagnosis/mortality/therapy MH - Diabetic Cardiomyopathies/diagnostic imaging/*etiology/mortality/physiopathology/therapy MH - Diastole MH - Echocardiography, Doppler MH - Female MH - Glycated Hemoglobin/metabolism MH - Hospitalization MH - Humans MH - Kaplan-Meier Estimate MH - Male MH - Middle Aged MH - Mitral Valve/diagnostic imaging/physiopathology MH - *Myocardial Contraction MH - Predictive Value of Tests MH - Prognosis MH - Proportional Hazards Models MH - Prospective Studies MH - ROC Curve MH - Risk Assessment MH - Risk Factors MH - Stress, Mechanical MH - Stroke Volume MH - Time Factors MH - Ventricular Dysfunction, Left/diagnostic imaging/*etiology/mortality/physiopathology/therapy MH - *Ventricular Function, Left PMC - PMC4738770 EDAT- 2016/02/05 06:00 MHDA- 2016/10/12 06:00 PMCR- 2016/02/03 CRDT- 2016/02/05 06:00 PHST- 2015/11/11 00:00 [received] PHST- 2016/01/08 00:00 [accepted] PHST- 2016/02/05 06:00 [entrez] PHST- 2016/02/05 06:00 [pubmed] PHST- 2016/10/12 06:00 [medline] PHST- 2016/02/03 00:00 [pmc-release] AID - 10.1186/s12933-016-0333-5 [pii] AID - 333 [pii] AID - 10.1186/s12933-016-0333-5 [doi] PST - epublish SO - Cardiovasc Diabetol. 2016 Feb 3;15:22. doi: 10.1186/s12933-016-0333-5.