Cardiovasc Diabetol: Type 2 diabetes can worsen right ventricular systolic dysfunction in hypertensive patients

Previous studies have found right ventricular (RV) systolic dysfunction
in patients with hypertension.
The purpose of this study was to evaluate the effects
of type 2 diabetes mellitus (T2DM) on ventricular systolic dysfunction and interventricular interactions in patients with essential hypertension using cardiac magnetic resonance signature tracing (CMR-FT).

Eighty-five hypertensive patients without T2DM (HTN[T2DM-]), 58 hypertensive patients with T2DM (HTN[T2DM+]), and 49 normal controls
were included.
The global radial, circumferential, and longitudinal peak strain (GRS, GCS, GLS) and the RV regional strain at basal, mid, and apical cavities were calculated by CMR-FT and compared
between control and different patient groups.
Reverse stepwise multivariate linear regression analysis was used to determine the influence of
T2DM and left ventricular (LV) strain on RV strain.

Strains at different locations in different groups of ventricles

From the control group to the HTN (T2DM-) group and then to the HTN (T2DM+) group, the longitudinal peak strain of the biventricular and the longitudinal strain of the right ventricular apical showed a significant deterioration
.
The median longitudinal strain of the right ventricle was significantly reduced in the two groups, and the overall radial, circumferential and right longitudinal strain of the left ventricle of the left heart was reduced in the HTN (T2DM+) group, but there was no such change
in the HTN (T2DM-) group.

There is no correlation between T2DM and ventricular strain in different groups of patients

Multivariate regression analysis based on covariate correction showed that T2DM was associated with left ventricular strain in hypertensive patients (LV GRS: β=- 4.
278, p=0.
004, model R2=0.
285; GCS: β=1.
498, p=0.
006, model R2=0.
363; GLS: β=1.
133, p=0.
007, model R2=0.
372) and right ventricular global radial (β=1.
454, p=0.
003, model R2=0.
142) are independently correlated
.
When T2DM and left ventricular global radial were included in multiple regression analysis, both T2DM and left ventricular global radial (β=0.
977 and 0.
362, p=0.
039 and <0.
001, model R2=0.
224) were correlated
with the overall radial independence of the right ventricle.

In summary, concomitant type 2 diabetes can worsen right ventricular systolic dysfunction in hypertensive patients, which may be related to T2DM superimposed on left ventricular dysfunction, suggesting adverse ventricular interactions
.

Original source:

Li, XM.
, Yan, WF.
, Jiang, L.
et al.
Impact of T2DM on right ventricular systolic dysfunction and interventricular interactions in patients with essential hypertension: evaluation using CMR tissue tracking.
Cardiovasc Diabetol 21, 238 (2022).
https://doi.
org/10.
1186/s12933-022-01678-3