Correlation between albuminuria and tissue Doppler-derived left ventricular myocardial performance index in patients with type 2 diabetes

J Clin Ultrasound. 2021 Jun;49(5):472-478. doi: 10.1002/jcu.22980. Epub 2021 Feb 1.

Abstract

Background: Albuminuria is considered as a significant predictor of cardiovascular morbidity and mortality in patients with diabetes mellitus. The main purpose of this study was to determine the correlation between albuminuria and global left ventricular (LV) function in patients with type 2 diabetes (T2D).

Methods: This observational study was conducted on 80 consecutive asymptomatic patients with T2D and an LV ejection fraction ≥55%. The patients were divided into two groups depending on the presence or absence of albuminuria. Echocardiography-derived indices of the LV function were then compared between these groups.

Results: The patients with albuminuria were older (mean ± SD: 60.37 ± 9.05 vs 54.52 ± 10.26 years of age, P = .01) and had higher hemoglobin A1c (HbA1c) levels (8.45 ± 1.97 vs 7.25 ± 1.93 mg/dL, P = .012) than those without albuminuria. Among the echocardiographic variables, the patients with albuminuria had higher LV Tei-index (median [lower-upper quartile]: 0.620 [0.455-0.824] vs 0.441 [0.336-0.586], P < .001), more prolonged early filling (E)-wave deceleration time (274.87 ± 75.97 vs 239.40 ± 61.35 ms, P = .032), increased interventricular septal wall thickness (1.11 ± 0.31 vs 0.95 ± 0.21 cm, P = .012), and lower mean early diastolic mitral annular velocity (7.57 ± 2.34 vs 8.68 ± 2.46 cm/s, P = .046) than those without albuminuria. Among risk factors, only albuminuria and HbA1c levels were associated with a significant increase in LV Tei-index (Beta = 0.426 and P < .001, Beta = 0.226 and P = .042, respectively).

Conclusion: The LV Tei-index was significantly higher in diabetic patients with than without albuminuria. Low HbA1c levels were correlated with a decrease in LV Tei-index.

Keywords: albuminuria; chronic kidney disease; echocardiography; left ventricular diastolic dysfunction.

MeSH terms

  • Albuminuria / complications*
  • Diabetes Mellitus, Type 2 / complications*
  • Echocardiography, Doppler*
  • Humans
  • Male
  • Middle Aged
  • Stroke Volume
  • Ventricular Dysfunction, Left / complications*
  • Ventricular Dysfunction, Left / diagnostic imaging*
  • Ventricular Dysfunction, Left / physiopathology