Acute hyperglycaemia is associated with a left ventricular mechanical phenotype resembling acute myocardial ischemia: a comparative speckle- tracking echocardiography study

Abstract This study was aimed to compare LV structural, functional, and mechanical characteristics of acute hyperglycaemia (≥ 11.1 mmol/L) in patients with diabetes mellitus (DM) without cardiovascular diseases (CVD) (group A, n = 52) and of acute myocardial ischemia (AMI) in patients without DM (group D, n = 55) using two-dimensional speckle-tracking echocardiography (2D-STE). Comparison groups included patients with well-controlled DM without complications (Group B, n = 20) and healthy controls (Group C, n = 20). We found that LV global longitudinal strain (GLS), as well as global circumferential strain (GCS) was comparably reduced in both groups A (-18.47+/-1.50% and − 19.86 ± 2.80%) and D (-17,21+/-3,35% and − 18.79 ± 3.40%) being significantly lower in comparison to groups B and C. Longitudinal mechanical dispersion index (LMDI) was highest in Group D and was significantly increased compared with Group A while circumferential MDI was equally increased in both groups A and D in comparison to control groups. Similar deterioration in peak apical rotation, LV twist and torsion were observed in both groups A and D. Simultaneously, AMI was associated with more pronounced LV remodelling in comparison to other three groups. In conclusion, acute hyperglycaemia alone induces LV mechanical dysfunction resembling AMI, affecting myocardial deformation and rotational mechanics despite the absence of overt CVD.