Effect of post-transplant diabetes mellitus on left ventricular longitudinal function and its prognostic value in heart transplant recipients
10.3760/cma.j.cn131148-20241217-00661
- VernacularTitle:移植术后糖尿病对心脏移植患者左心室功能影响及其预后价值
- Author:
Yiwei ZHANG
1
;
Yanting ZHANG
;
Yuman LI
;
Shuangshuang ZHU
;
Wei SUN
;
Yuji XIE
;
Ye ZHU
;
Mingxing XIE
;
Li ZHANG
Author Information
1. 华中科技大学同济医学院附属协和医院超声医学科，湖北省影像医学临床医学研究中心，分子影像湖北省重点实验室，武汉 430022
- Publication Type:Journal Article
- Keywords:
Echocardiography;
Heart transplantation;
Post-transplant diabetes mellitus;
Strain;
Prognosis
- From:
Chinese Journal of Ultrasonography
2025;34(5):377-382
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the left ventricular（LV）function in heart transplant（HTx）patients with post-transplant diabetes（PTDM），and to examine the relevance of PTDM and LV function to the patient's prognosis.Methods:Two hundred and thirteen adult HTx patients who underwent echocardiography at Union Hospital，Tongji Medical College，Huazhong University of Science and Technology between January 2018 and January 2022 were prospectively included. The patients were divided into PTDM group（ n=86）and Non-PTDM group（ n=127）. LV function parameters were acquired using conventional and two-dimensional speckle-tracking echocardiography（2D-STE），and were compared between the two groups. The primary endpoints included all-cause mortality or transplant-related readmission. Results:Compared with Non-PTDM group，the LV mass of PTDM group was higher，the LV ejection fraction，LV global longitudinal strain（GLS），peak systolic global longitudinal strain rate，and early diastolic global longitudinal strain rate（dGLSr）were lower（all P＜0.05）. After a median follow-up period of 37.6（29.3）months，27 patients experienced clinical events. A multivariate analysis revealed that PTDM（ HR=2.198，95% CI=1.018-4.743， P=0.045）and low GLS（ HR=6.456，95% CI=2.889-14.426， P＜0.001）were independent predictors of adverse clinical events after adjustment for dGLSr，body mass index and age. After subdividing the two groups into 4 subgroups by the cutoff value of GLS（16.5%），the prognosis was worst for HTx patients with PTDM and low GLS. Conclusions:HTx patients with PTDM have worse LV systolic and diastolic function than those without PTDM. Management of HTx patients with PTDM may be improved using GLS guidance.
