Insulin Resistance and Subclinical Myocardial Dysfunction in Type 2 Diabetes: A Cross-sectional Study

Abstract

Introduction: Left atrial (LA) strain and left ventricular (LV) global longitudinal strain (GLS) on two-dimensional echocardiography in asymptomatic Type 2 diabetes mellitus (T2DM) patients might help recognise subclinical myocardial dysfunction in these patients. Since T2DM is associated with underlying insulin resistance (IR), we explored the association of IR estimated by homeostatic model assessment of IR (HOMA-IR) with LA and LV strain. Materials and Methods: This cross-sectional study was undertaken in patients with T2DM with Stage A heart failure (HF). Detailed echocardiographic assessment of the LA and LV functions using 2D speckle-tracking echocardiography was carried out. Participants were categorised into two groups for analysis, using the lower limit of the highest HOMA-IR quartile as the cut-off point. Results: A total of 93 patients (51 males and 42 females; median age 57 years) were included in the analysis. Group A (IR <75th percentile) had significantly higher LA volume (34.52 vs. 29.71 mL) and aortic valve (AV) velocity (1.30 vs. 1.24 m/s) than Group B (IR >75th percentile). LV strain in Group A was −16.82 ± 2.90 and in Group B was −16.55 ± 2.19, with no significant difference. Similarly, the LA strain in both groups was statistically insignificant. Conclusion: In T2DM patients with Stage A HF, IR does not correlate with LA strain or LVGLS, yet it significantly associates with an increased LA volume and AV velocity.