PMID- 29526563
OWN - NLM
STAT- MEDLINE
DCOM- 20191119
LR  - 20191119
IS  - 1097-6795 (Electronic)
IS  - 0894-7317 (Linking)
VI  - 31
IP  - 5
DP  - 2018 May
TI  - Dobutamine Stress Echocardiography Unmasks Early Left Ventricular Dysfunction in 
      Asymptomatic Patients with Uncomplicated Type 2 Diabetes: A Comprehensive 
      Two-Dimensional Speckle-Tracking Imaging Study.
PG  - 587-597
LID - S0894-7317(17)30874-X [pii]
LID - 10.1016/j.echo.2017.12.006 [doi]
AB  - BACKGROUND: Discrepancies are present in the literature on resting myocardial 
      mechanics in patients with uncomplicated type 2 diabetes mellitus (T2DM). Data 
      are noticeably sparse regarding circumferential function and torsional mechanics. 
      Resting deformation imaging may not be sensitive enough to detect subtle 
      dysfunctions. The aim of this study was thus to comprehensively evaluate 
      myocardial mechanics in patients with T2DM at rest and to investigate whether 
      dobutamine stress echocardiography could unmask functional alterations that would 
      remain otherwise subtle at rest. METHODS: Forty-four patients with T2DM and 35 
      healthy control subjects of similar age and sex were prospectively recruited. 
      After conventional echocardiography, myocardial mechanics was evaluated at rest 
      and during low-dose dobutamine stress echocardiography (target heart rate, 110 
      beats/min). RESULTS: Patients with T2DM presented with altered global diastolic 
      function but preserved systolic function. Deformation imaging indexes were 
      similar between groups at rest, but significant differences were noticed under 
      dobutamine infusion for longitudinal strain (-21.2 +/- 2.4% vs -24.2 +/- 2.5%, 
      P < .001), circumferential strain (apex, -32.3 +/- 5.3% vs -36.3 +/- 5.3%, P = .002; 
      papillary muscle, -25.6 +/- 3.2% vs -28.0 +/- 3.6%, P = .001; base, -23.2 +/- 3.6% vs 
      -25.3 +/- 3.8%, P = .03), apical (11.2 +/- 4.4 degrees  vs 14.1 +/- 6.3 degrees , P = .020) and basal 
      (-12.2 +/- 3.3 degrees  vs -14.3 +/- 3.9 degrees , P = .021) rotation, and twist (21.9 +/- 5.9 degrees  vs 
      26.8 +/- 8.3 degrees , P = .007). Multivariate analysis identified epicardial fat, 
      dyslipidemia, and fasting glycaemia as significant contributors to the changes 
      from rest to dobutamine. CONCLUSIONS: These findings demonstrate the usefulness 
      of dobutamine stress echocardiography in establishing impairments in myocardial 
      mechanics in patients with uncomplicated T2DM. Systemic metabolic disturbances 
      and epicardial fat act as the main contributors to the blunted response to 
      dobutamine stress in these patients.
CI  - Copyright (c) 2018 American Society of Echocardiography. Published by Elsevier Inc. 
      All rights reserved.
FAU - Philouze, Clothilde
AU  - Philouze C
AD  - EA4278 LaPEC, Laboratory of Cardiovascular Pharm-Ecology, Avignon University, 
      Avignon, France.
FAU - Obert, Philippe
AU  - Obert P
AD  - EA4278 LaPEC, Laboratory of Cardiovascular Pharm-Ecology, Avignon University, 
      Avignon, France.
FAU - Nottin, Stephane
AU  - Nottin S
AD  - EA4278 LaPEC, Laboratory of Cardiovascular Pharm-Ecology, Avignon University, 
      Avignon, France.
FAU - Benamor, Asma
AU  - Benamor A
AD  - EA4278 LaPEC, Laboratory of Cardiovascular Pharm-Ecology, Avignon University, 
      Avignon, France.
FAU - Barthez, Olivier
AU  - Barthez O
AD  - Cardiology Department, Duffaut Hospital Center, Avignon, France.
FAU - Aboukhoudir, Falah
AU  - Aboukhoudir F
AD  - EA4278 LaPEC, Laboratory of Cardiovascular Pharm-Ecology, Avignon University, 
      Avignon, France; Cardiology Department, Duffaut Hospital Center, Avignon, France. 
      Electronic address: faboukhoudir@ch-avignon.fr.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20180308
PL  - United States
TA  - J Am Soc Echocardiogr
JT  - Journal of the American Society of Echocardiography : official publication of the 
      American Society of Echocardiography
JID - 8801388
SB  - IM
MH  - Asymptomatic Diseases
MH  - Diabetes Mellitus, Type 2/*complications
MH  - Diastole
MH  - Echocardiography, Stress/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Stroke Volume/*physiology
MH  - Systole
MH  - Ventricular Dysfunction, Left/complications/*diagnosis/physiopathology
MH  - Ventricular Function, Left/*physiology
OTO - NOTNLM
OT  - Asymptomatic patients
OT  - Dobutamine stress echocardiography
OT  - Epicardial adipose tissue
OT  - Regional myocardial function
OT  - Speckle-tracking imaging
OT  - Uncomplicated type 2 diabetes
EDAT- 2018/03/13 06:00
MHDA- 2019/11/20 06:00
CRDT- 2018/03/13 06:00
PHST- 2017/08/16 00:00 [received]
PHST- 2018/03/13 06:00 [pubmed]
PHST- 2019/11/20 06:00 [medline]
PHST- 2018/03/13 06:00 [entrez]
AID - S0894-7317(17)30874-X [pii]
AID - 10.1016/j.echo.2017.12.006 [doi]
PST - ppublish
SO  - J Am Soc Echocardiogr. 2018 May;31(5):587-597. doi: 10.1016/j.echo.2017.12.006. 
      Epub 2018 Mar 8.