Biomarkers and their involvement in the early diagnosis of right ventricular dysfunction in type 2 Diabetes Mellitus

OBJECTIVE During the last years, left ventricular dysfunction in diabetes was intensely studied and it is recognized as a complication of diabetes, while data regarding the right ventricular dysfunction is still incomplete. The aim of this study was to find a correlation between inflammatory biomarkers, adiponectin and right ventricular strain and strain rate properties in patients with diabetes mellitus type 2. METHODS We studied 29 patients with type 2 diabetes mellitus (DM), with coexisting cardiovascular complications, coronary artery disease and high blood pressure (group 1- DM+CV, aged 61.2 ± 4.2 years); and 22 patients with type 2 diabetes and controlled high blood pressure only, with no other coexisting cardiovascular complications (group 2- DM, aged 60.86 ± 4.4 years). We evaluated the right ventricular (rv) function through vector velocity imaging (vvi)and determined the inflammatory profile through assessment of the following biomarkers: high sensitivity C- reactive protein (hsCRP), tumor necrosis factor-alpha (TNF-alfa), lipoprotein associated phospholipase A2 (Lp-PLA2) and adiponectin level for each patient. RESULTS VVI revealed significantly lower values of systolic strain and strain rates (SR) in the basal segment of the RV free wall in group I patients (DM+CV) as compared to group II patients (DM) which indicates higher impairment of RV systolic function in patients with diabetes and other cardiovascular complications. In both groups strain and strain rate values were correlated with Lp-PLA2 activity levels. CONCLUSIONS In Type 2 diabetes mellitus we identified a low-grade inflammatory status correlated with right ventricular systolic dysfunction.