自动心肌运动定量技术评价2型糖尿病合并肾功能不全患者左心室收缩功能

doi:10.3969/j.issn.1006-5725.2025.03.017

Abstract

Abstract:

Objective To evaluate the left ventricular systolic function of patients with type 2 diabetes mellitus （T2DM） combined with renal insufficiency （CKD） by applying automated myocardial motion quantification （aCMQ） and to investigate its correlation with clinical biochemical indexes. Methods 80 patients with T2DM were enrolled， divided into DM group （without CKD， n = 40） and DN group （with CKD， n = 40）， and 40 healthy volunteers were selected as the control group. The general clinical data of all subjects were recorded， and routine echocardiography and aCMQ were performed to obtain routine ultrasonographic measurements and aCMQ-related parameters. Results Comparison of aCMQ-related parameters： The differences in LV global longitudinal strain （LVGLS）， LV apical 2-chamber longitudinal strain （LVAP2LS）， LV apical 3-chamber longitudinal strain （LVAP3LS）， and LV apical 4-chamber longitudinal strain （LVAP4LS） among the three groups were all statistically significant （P < 0.05）. The differences in LV global circumferential strain （LVGCS） between the DN group and the other two groups were statistically significant （P < 0.05）. The differences in LV short-axis basal segment cyclic strain （LVSAXBCS）， LV short-axis middle segment cyclic strain （LVSAXMCS）， and LV short-axis apical segment cyclic strain （LVSAXACS） were not statistically significant （P > 0.05）. LV strain was negatively correlated with Hs- CRP， GA， HbA1c， creatinine， urea， and uric acid， and positively correlated with eGFR. Correlation. High-sensitivity C-reactive protein （Hs-CRP）， glycated albumin （GA） and eGFR showed good correlation with LV strain parameters. Conclusion The aCMQ technique can detect the deterioration of left ventricular function in patients with type 2 diabetes mellitus combined with renal insufficiency at an early stage， and the correlation between left ventricular strain parameters and hs-CRP， GA and eGFR can help to better assess their cardiac involvement.

Key words: aCMQ technique, echocardiography, type 2 diabetes mellitus, diabetic nephropathy

CLC Number:

R445.1

Yan LI,Ziran JIN,Haotian SUN,Xuan LIU,Jing. GAO. Assessment of left ventricular systolic function in type 2 diabetes patients with renal insufficiency by aCMQ technique[J]. The Journal of Practical Medicine, 2025, 41(3): 414-421.

Figures/Tables 10

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References 27

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观察指标	DM组	DN组	对照组	F值	P值
年龄/岁	56.70 ± 6.57	57.83 ± 8.26	54.10 ± 6.36	2.170	0.120
身高/cm	163.40 ± 5.61	163.20 ± 5.30	163.10 ± 6.85	0.020	0.980
BMI/（kg/㎡）	23.62 ± 1.33	24.13 ± 1.78	23.55 ± 1.45	1.231	0.297
病程/年	8.12 ± 2.47	13.67 ± 5.01	-	-	-
收缩压/mmHg	124.93 ± 5.41	135.10 ± 14.76^?#	117.47 ± 7.33	23.427	< 0.001
舒张压/mmHg	76.70 ± 5.50	85.67 ± 7.72^?#	74.00 ± 3.74	32.333	< 0.001
心率/（次/min）	71.87 ± 9.54	75.67 ± 7.36	71.37 ± 9.18	2.169	0.120
空腹血糖/（mmol/L）	7.59 ± 0.34^?	7.93 ± 0.52^?	5.27 ± 0.71	211.144	< 0.001
HbA1c/%	8.77 ± 2.12^?	9.57 ± 2.94^?	4.41 ± 0.31	52.442	< 0.001
TC/（mmol/L）	4.73 ± 0.35	5.39 ± 0.61^?	4.23 ± 0.21	55.575	< 0.001
TG/（mmol/L）	2.08 ± 0.69	2.88 ± 0.94^?	1.14 ± 0.51	42.505	< 0.001
LDL-C/（mmol/L）	2.93 ± 0.41^?	3.04 ± 0.45^?	2.32 ± 0.65	17.071	< 0.001
HDL-C/（mmol/L）	1.11 ± 0.23^?	1.12 ± 0.20^?	1.64 ± 0.45	27.687	< 0.001
eGFR/［mL/（min·1.73 m²）］	94.23 ± 4.06^?	37.90 ± 10.77^?#	105.30 ± 5.77	708.849	< 0.001
肌酐/（μmol/L）	69.00 ± 17.06^?	164.33 ± 38.86^?#	56.80 ± 9.71	164.636	< 0.001
尿素/（mmol/L）	7.71 ± 0.78^?	10.15 ± 1.67^?#	5.25 ± 1.08	118.344	< 0.001
尿酸/（μmol/L）	350.33 ± 87.65^?	479.27 ± 118.31^?#	253.47 ± 39.89	49.629	< 0.001
hs-CRP/（mg/L）	2.18 ± 1.05^?	8.73 ± 1.49^?#	1.02 ± 0.48	438.758	< 0.001
GA/%	16.54 ± 1.23^?	18.77 ± 1.89^?#	13.60 ± 0.88	103.204	< 0.001

观察指标	DM组	DN组	对照组	F值	P值
LVIDd/mm	45.73 ± 3.95	44.97 ± 3.87	43.47 ± 4.38	2.405	0.096
LVISd/mm	29.33 ± 4.63	30.70 ± 4.36	28.17 ± 4.09	2.529	0.086
LVEDV/mL	61.13 ± 9.34	64.13 ± 10.56	58.60 ± 11.17	2.135	0.124
LVESV/mL	26.77 ± 4.43	28.37 ± 5.39^?	23.53 ± 2.87	9.591	< 0.001
IVSd/mm	8.89 ± 0.90^?	9.56 ± 1.24^?#	8.30 ± 0.71	12.620	< 0.001
LVPWd/mm	8.55 ± 0.71^?	9.47 ± 1.47^?#	7.90 ± 1.02	15.311	< 0.001
LVRWT	0.38 ± 0.04	0.44 ± 0.02^?#	0.36 ± 0.04	39.148	< 0.001
LVMI/（g/m²）	79.53 ± 6.55^?	85.07 ± 6.52^?	70.37 ± 10.32	25.847	< 0.001
LVEF/%	64.23 ± 5.74	63.30 ± 6.59	66.07 ± 5.85	1.613	0.205

变量	DM组	DN组	对照组	F值	P值
LVGLS	-15.59 ± 2.14^?	-13.94 ± 1.26^?#	-18.09 ± 3.06	25.258	< 0.001
LVAP2LS	-15.71 ± 2.21^?	-13.95 ± 1.30^?#	-17.84 ± 3.32	19.344	< 0.001
LVAP3LS	-15.67 ± 2.00^?	-13.45 ± 1.32^?#	-17.46 ± 2.92	25.507	< 0.001
LVAP4LS	-15.45 ± 1.97^?	-13.86 ± 1.31^?#	-17.70 ± 3.64	17.768	< 0.001
LVGCS	-23.12 ± 4.28	-20.50 ± 5.24^?#	-25.53 ± 4.13	9.048	< 0.001
LVSAXBCS	-22.15 ± 4.76	-21.36 ± 4.04	-23.28 ± 3.92	1.539	0.220
LVSAXMCS	-24.92 ± 3.96	-23.60 ± 4.73	-25.66 ± 4.95	1.559	0.216
LVSAXACS	-25.86 ± 5.85	-24.74 ± 6.11	-28.06 ± 6.96	2.135	0.124

指标	LVGLS		LVAP2LS		LVAP3LS		LVAP4LS		LVGCS
指标	r值	P值	r值	P值	r值	P值	r值	P值	r值	P值
hs-CRP	-0.537	< 0.001	-0.517	< 0.001	-0.594	< 0.001	-0.492	< 0.001	-0.344	< 0.001
GA	-0.494	< 0.001	-0.435	< 0.001	-0.470	< 0.001	-0.437	< 0.001	-0.353	< 0.001
eGFR	0.521	< 0.001	0.494	< 0.001	0.559	< 0.001	0.465	< 0.001	0.368	< 0.001
HbA1c	-0.420	< 0.001	-0.388	< 0.001	-0.402	< 0.001	-0.390	< 0.001	-0.273	0.009
肌酐	-0.428	< 0.001	-0.421	< 0.001	-0.501	< 0.001	-0.424	< 0.001	-0.304	0.004
尿素	-0.425	< 0.001	-0.377	< 0.001	-0.442	< 0.001	-0.375	< 0.001	-0.325	0.002
尿酸	-0.401	< 0.001	-0.363	< 0.001	-0.432	< 0.001	-0.342	< 0.001	-0.222	0.036

参数	AUC	P值	敏感度	特异度	截断值	95%CI
LVAP2LS	0.781	< 0.001	0.633	0.767	-15.100	0.682 ~ 0.879
LVAP3LS	0.808	< 0.001	0.600	0.867	-14.900	0.716 ~ 0.900
LVAP4LS	0.780	< 0.001	0.500	0.900	-14.100	0.682 ~ 0.878
LVGLS	0.838	< 0.001	0.833	0.667	-16.250	0.755 ~ 0.920
LVGCS	0.716	0.001	0.867	0.500	-25.740	0.606 ~ 0.825

Assessment of left ventricular systolic function in type 2 diabetes patients with renal insufficiency by aCMQ technique

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