Evaluation of Myocardial Performance in Hypertensive Patients with Type 2 Diabetes and Normal Ejection Fraction

Abstract

Diabetes (DM) and hypertension (HT) cause changes in cardiac performance. Long-term diabetes and hypertension can lead to changes in cardiac contractility, reduced left ventricular efficiency and heart failure. The aim of this study is to evaluate the effect of the coexistence of diabetes mellitus and hypertension on left ventricular myocardial performance and structural changes. The study involved 45 patients with essential hypertension and type 2 diabetes (14 males and 31 females, their mean age was 53.28 ± 13.28 years), and 45 healthy subjects (10 males and 35 females, their mean age was 48.11 ± 13.07 years) as a control group. Transthoracic echocardiography was done for all patients. The echocardiographic measurements included: left ventricle internal diameter at end diastole (LVIDd), left ventricle internal diameter at end systole (LVIDs), peak velocity of early transmitral flow (E), peak velocity of late transmitral flow (A), ejection fraction (EF%), isovolumic relaxation time (IVRT), isovolumic contraction time (IVCT) and ejection time (ET) from which the index of myocardial performance (IMP) was calculated. Results revealed a significant change in the ratio (E/A) between patients and controls (-32.45%) with p value < 0.05, and the change in (LVIDd) and (LVIDs) between patients and control groups were (4.61%) and (0.754%) respectively with insignificant p value. The change in IMP was (44.65%), with p value < 0.05, and the change in ejection fraction (EF%) was (-1.49) with p value > 0.05. In conclusion, diabetic patients with hypertension had an increase in IMP and reduced E/A indicating deterioration in cardiac performance despite normal ejection fraction and insignificant change in LV dimensions.