Assessment of Left Ventricular Diastolic Functions and Myocardial Performance Index in Patients with Prediabetes

Aim: Heart failure (HF) is a progressive chronic syndrome characterized by a decreased in functional capacity and quality of life, and an increased in morbidity and mortality. Prediabetes is the first phase of DM and defined as presence of impaired glucose tolerance (IGT), impaired fasting glucose (IFG) or both. Although the association between DM and diastolic dysfunction has been established previously, the association between newly diagnosed prediabetes and diastolic functions is unclear. This study aims to reveal the relationship between prediabetes and diastolic dys-function. Material and Method: The present study is a single-center, prospective, cross-sectional study. 110 patients who were performed oral glucose tolerance test (OGTT) and newly diagnosed of prediabetes, diabetes or normal glucose metabolism (control) were included in the study. Systolic, diastolic and other cardiac parameters of patients were assessed by conventional echocardiography and tissue Doppler imaging. Control, prediabetes and diabetes groups were compared via mitral valve flow velocities and tissue Doppler findings, in terms of diastolic functions. Results: Mean mitral valve E/A (control: 1.10±0.26; prediabetes: 0.90±0.16; and diabetes: 0.93±0.24; p=0.001) and global tissue Doppler Em/Am ratios (control: 1.13±0.33; prediabet: 0.94±0.33; dia-betes: 0.92±0.26; p=0.001) were found to be decreased in prediabetic group, as similar to diabetic patients. Additionally deceleration times, isovolumic relaxation times and myocardial perfor-mance index were found to be significantly increased in prediabetic and diabetic groups when compared to control group. In addition a correlation between fasting blood glucose and OGTT 2nd hr blood glucose and mitral flow E/A and Doppler global Em/Am ratios was observed. Conclusion: In this study comparing diastolic dysfunction indices and MPI with diabetic patients and control group, it was determined that diastolic dysfunction was present in prediabetic patients. This study found that diabetic complications even started at these glucose levels and that diastolic dysfunction correlated with blood glucose levels