Arrêt de service programmé du vendredi 10 juin 16h jusqu’au lundi 13 juin 9h. Pour en savoir plus
Accéder directement au contenu Accéder directement à la navigation
Article dans une revue

Resting Left Ventricular Global Longitudinal Strain to Identify Silent Myocardial Ischemia in Asymptomatic Patients with Diabetes Mellitus

Abstract : Background: Screening for silent coronary artery disease in asymptomatic patients with diabetes mellitus (DM) is challenging and controversial. In this context, it seems crucial to identify early markers of coronary artery disease. Methods: The aim of this study was to investigate the incremental value of resting left ventricular (LV) global longitudinal strain (GLS) for the prediction of positive results on stress (exercise or dobutamine) transthoracic echocardiography in 273 consecutive asymptomatic high-risk patients with DM. Positive results on stress transthoracic echocardiography were defined as stress-induced LV wall motion abnormalities (new or worsening preexisting abnormalities). Results: Compared with patients with negative stress results, those with positive stress results (n = 28 [10%]) more frequently had cardiovascular risk factors, complications of DM, vascular disease, moderate and severe calcification of the aortic valve and mitral annulus, and worse resting LV GLS (-16.7 +/- 2.9% vs-19.0 +/- 1.9%, P .001). On multivariable logistic regression analysis, DM duration 10 years, diabetic retinopathy, LV hypertrophy, and impaired LV GLS (odds ratio, 1.39 [95% CI, 1.14-1.70] per percentage increase; odds ratio, 5.16 [95% CI, 1.96-13.59] for LV GLS worse than-18%) were independently associated with positive results on stress transthoracic echocardiography. The area under the curve to predict positive results was 0.74 for LV GLS with a cutoff of-18.0% (sensitivity 68%, specificity 78%). The area under the curve of the multivariable model to predict test results was improved by the addition of LV GLS (P < .001), with a bias-corrected area under the curve after bootstrapping of 0.842 [95% CI, 0.753-0.893]. Conclusions: The present findings show that resting LV GLS is associated with the presence of silent ischemia and could be useful to better identify asymptomatic patients with DM who might benefit from coronary artery disease screening. (J Am Soc Echocardiogr 2022;35:258-66.)
Type de document :
Article dans une revue
Liste complète des métadonnées

https://hal-u-picardie.archives-ouvertes.fr/hal-03619097
Contributeur : Louise Dessaivre Connectez-vous pour contacter le contributeur
Soumis le : jeudi 24 mars 2022 - 18:43:47
Dernière modification le : vendredi 25 mars 2022 - 03:00:20

Identifiants

Collections

Citation

Gregoire Albenque, Dan Rusinaru, Manon Bellaiche, Chloe Di Lena, Paul Gabrion, et al.. Resting Left Ventricular Global Longitudinal Strain to Identify Silent Myocardial Ischemia in Asymptomatic Patients with Diabetes Mellitus. JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, 2022, 35 (3), pp.258-266. ⟨10.1016/j.echo.2021.10.013⟩. ⟨hal-03619097⟩

Partager

Métriques

Consultations de la notice

17