Arq Bras Cardiol: Imagem cardiovasc 2022; 35(2): eabc293

Role of Strain in the Early Diagnosis of Diabetic Cardiomyopathy

DOI: 10.47593/2675-312X/20223502eabc293

Abstract

Background

Advanced echocardiography using two- and three-dimensional myocardial strain proposes to identify subclinical systolic dysfunction in different clinical conditions. Strain assessment plays an important role in the early diagnosis of diabetic cardiomyopathy in diabetes mellitus (DM). However, the findings of published articles are heterogeneous. Here we conducted a systematic review to analyze the current role of strain assessment in patients with DM.

Methods

This systematic review of five databases identified 19 studies that used two-dimensional strain and 8 studies that used three-dimensional strain.

Results

The studies of two-dimensional strain included 1,774 DM patients (mean age, 57.1 years; median age, 55 years; 47.5% women), while those of three-dimensional strain included 488 DM patients (mean age, 55.7 years; median age, 63 years; 51% women). Global longitudinal strain was the myocardial deformation marker that differed most frequently between the DM and control groups.

Conclusion

Myocardial strain imaging by two- and three-dimensional speckle tracking echocardiography allows the identification of subclinical systolic dysfunction in DM patients, and differences become more marked when associated with risk factors and ventricular remodeling.