THE JOURNAL OF TEHRAN UNIVERSITY HEART CENTER

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The Journal of Tehran University Heart Center Mahdi Najafi et al. Munro J, Sandler A. Risk factors of delayed extubation, prolonged length of stay in the intensive care unit, and mortality in patients undergoing coronary artery bypass graft with fast-track cardiac anesthesia: a new cardiac risk score. Anesthesiology 1999;91:936- 944. 19. Bucerius J, Gummert JF, Walther T, Doll N, Falk V, Schmitt DV, Mohr FW. Predictors of prolonged ICU stay after on-pump versus off-pump coronary artery bypass grafting. Intensive Care Med 2004;30:88-95. 20. Hein OV, Birnbaum J, Wernecke K, England M, Konertz W, Spies C. Prolonged intensive care unit stay in cardiac surgery: risk factors and long-term-survival. Ann Thorac Surg 2006;81:880-885. 21. Staat P, Cucherat M, George M, Lehot JJ, Jegaden O, André-Fouët X, Beaune J. Severe morbidity after coronary artery surgery: development and validation of a simple predictive clinical score. Eur Heart J 1999;20:960-966. 22. Kurki TS, Kataja M. Preoperative prediction of postoperative morbidity in coronary artery bypass grafting. Ann Thorac Surg 1996;61:1740-1745. 23. Miller KH. Factors influencing selected lengths of ICU stay for coronary artery bypass patients. J Cardiovasc Nurs 1998;12:52-61. 24. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2010;33:S62-69. 25. Silbernagel G, Grammer TB, Winkelmann BR, Boehm BO, März W. Glycated hemoglobin predicts all-cause, cardiovascular, and cancer mortality in people without a history of diabetes undergoing coronary angiography. Diabetes Care 2011;34:1355-1361. 26. Selvin E, Steffes MW, Zhu H, Matsushita K, Wagenknecht L, Pankow J, Coresh J, Brancati FL. Glycated hemoglobin, diabetes, and cardiovascular risk in nondiabetic adults. N Engl J Med 2010;362:800-811. 27. Liu Y, Yang YM, Zhu J, Tan HQ, Liang Y, Li JD. Prognostic significance of hemoglobin A1c level in patients hospitalized with coronary artery disease. A systematic review and meta-analysis. Cardiovasc Diabetol 2011;10:98. 28. Medhi M, Marshall MC, Jr, Burke HB, Hasan R, Nayak D, Reed G, LaFaro R, Southren AL. HbA1c predicts length of stay in patients admitted for coronary artery bypass surgery. Heart Dis 2001;3:77- 79. 29. O’Sullivan CJ, Hynes N, Mahendran B, Andrews EJ, Avalos G, Tawfik S, Lowery A, Sultan S. Haemoglobin A1c (HbA1C) in nondiabetic and diabetic vascular patients. Is HbA1C an independent risk factor and predictor of adverse outcome Eur J Vasc Endovasc Surg 2006;32:188-197. 30. Goode KM, John J, Rigby AS, Kilpatrick ES, Atkin SL, Bragadeesh T, Clark AL, Cleland JG. Elevated glycated haemoglobin is a strong predictor of mortality in patients with left ventricular systolic dysfunction who are not receiving treatment for diabetes mellitus. Heart 2009;95:917-923. 176
TEHRAN HEART CENTER Original Article Obvious or Subclinical Right Ventricular Dysfunction in Diabetes Mellitus (Type II): An Echocardiographic Tissue Deformation Study Mozhgan Parsaee, MD * , Parvaneh Bahmanziari, MD, Maryam Ardeshiri, MD, Maryam Esmaeilzadeh, MD Rajaei Cardiovascular, Medical and Research Center, Tehran University of Medical Sciences, Tehran, Iran. Received 20 May 2011; Accepted 07 March 2012 Abstract Background: Diabetes mellitus is capable of impairing the myocardial function. Several studies have documented the influential impact of diabetes mellitus on the left ventricular function. The right ventricular function plays a significant role in the overall myocardial contractility; hence, this study was undertaken to evaluate the effect of diabetes mellitus type II on the right ventricular function. Methods: Twenty-two diabetic patients without any coronary artery disease, hypertension, or left ventricular dysfunction were studied. The right ventricular end diastolic diameter, tricuspid plane systolic excursion, right ventricular inflow Doppler parameters, longitudinal myocardial velocities, and deformation indices from the basal and apical segments of the right ventricular free wall of the case group were measured. The control group consisted of 22 healthy individuals. Results: The tricuspid annular plane systolic excursion (TAPSE) and tricuspid peak early to peak late diastolic flow velocities ratio (E/A) in the diabetic patients were significantly lower than those of the control group patients (18.9 vs. 23.2, p value < 0.001 and 0.96 vs. 1.21, p value = 0.012), but there were no significant differences in the right ventricular end diastolic diameter and the right ventricular Tei index between the two groups (p value = 0.72). The right ventricular basal peak myocardial systolic velocity (SM) (12 cm/sec vs. 13.4 cm/sec; p value = 0.03), basal and apical right ventricular free wall systolic strain (-13.3% and -18.7% vs. -20.2% and -25.7%; p value = 0.001), and apical strain rate (-1.2 1/s vs. -1.6 1/s; p value = 0.008 ) were significantly lower in the study group. There was a weak correlation between the right ventricular function and HbA1c as well as the duration of diabetes mellitus and C-reactive protein. Conclusion: Our results suggest that diabetes mellitus type II can influence the right ventricular function in the absence of coronary artery disease, diastolic dysfunction, and pulmonary hypertension. J Teh Univ Heart Ctr 2012;7(4):177-181 This paper should be cited as: Parsaee M, Bahmanziari P, Ardeshiri M, Esmaeilzadeh M. Obvious or Subclinical Right Ventricular Dysfunction in Diabetes Mellitus (Type II): An Echocardiographic Tissue Deformation Study. J Teh Univ Heart Ctr 2012;7(4):177-181. Keywords: Echocardiography • Diabetes mellitus • Ventricular function, right * Corresponding Author: Mozhgan Parsaee, Assistant Professor of Cardiology, Department of Echocardiography, Rajaei Cardiovascular, Medical and Research Center, Vali-Asr Ave. Adjacent to Mellat Park, Tehran, Iran. 1996911151. Tel: +98 21 23922930. Fax: +98 21 2055594. E-mail: parsaeemozhgan@yahoo.com. The Journal of Tehran University Heart Center 177
Page 1 and 2: Zohair Yousef Al-halees, MD , FRCSC
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