Echocardiography findings in patients with ST segment elevation myocardial infarction and type 2 diabetes mellitus treated with primary percutaneous coronary angioplasty

Abstract

Background: The development of heart failure following myocardial infarction (MI) in patients with diabetes mellitus (DM) is related to the extent of the infarction zone and underlying primary diabetic cardiomyopathy. Echocardiography allows the monitoring of systolic dysfunction following MI. Left ventricular ejection fraction (LVEF) is one of the most important prognostic indicators in patients after MI.
Methods: The aim of the study was to assess the effect of type 2 DM on postinfarct left ventricular (LV) remodeling in patients with acute ST segment elevation MI treated with primary percutaneous transluminal coronary angioplasty. One hundred and ten patients were enrolled to the study and divided into two groups: group 1 included 41 subjects with type 2 DM, and group 2 included 57 subjects without DM. Echocardiographic parameters of LV systolic function including LVEF, LV end-diastolic volume (LVEDV), and LV end-systolic volume (LVESV) were compared between the study groups.
Results: Both study groups showed statistically significant decrease in LVEF. However, significant LV dilatation was seen only in patients without DM but not in patients with DM.
Conclusion: Long-term DM leads to the remodeling and the fibrosis of cardiac interstitial tissue, limiting acute ventricular dilatation and resulting in stiffening of the heart.