Meta-Analysis
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Apr 15, 2024; 15(4): 783-792
Published online Apr 15, 2024. doi: 10.4239/wjd.v15.i4.783
Application of three-dimensional speckle tracking technique in measuring left ventricular myocardial function in patients with diabetes
Zheng Li, Ying Qian, Chun-Yun Fan, Yong Huang
Zheng Li, Ying Qian, Chun-Yun Fan, Department of Ultrasound, The People’s Hospital of Danyang, Danyang Hospital of Nantong University, Danyang 212300, Jiangsu Province, China
Yong Huang, Department of Endocrinology, The People’s Hospital of Danyang, Danyang Hospital of Nantong University, Danyang 212300, Jiangsu Province, China
Author contributions: Li Z and Qian Y were responsible for the study concept and designed the systematic review protocol; Qian Y and Huang Y performed the study selection and data extraction; Li Z and Fan CY performed the statistical analyses; Qian Y and Huang Y prepared the outlines and wrote the manuscript; and all the authors have contributed to the completion of this paper.
Conflict-of-interest statement: No conflicts of interest exit in the submission of this manuscript.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yong Huang, MM, Department of Endocrinology, The People’s Hospital of Danyang, Danyang Hospital of Nantong University, No. 2 Xinmin West Road, Danyang 212300, Jiangsu Province, China. dysrmyyhy@163.com
Received: December 5, 2023
Peer-review started: December 5, 2023
First decision: December 18, 2023
Revised: December 28, 2023
Accepted: March 7, 2024
Article in press: March 7, 2024
Published online: April 15, 2024
Processing time: 128 Days and 18 Hours
ARTICLE HIGHLIGHTS
Research background

Diabetic cardiomyopathy is a chronic complication, which is a critical reason of poor prognosis and even death in patients with diabetes mellitus (DM). Additionally, numerous reports have implied that DM could raise the occurrence of heart disorder, hypertension, and other illnesses, and could worsen coronary artery illness. Therefore, early detection of left ventricular systolic function (LVSF) damage in DM, necessary treatment is especially essential. Three-dimensional speckle tracking technique (3D-STI) is of beneficial worth in the assessment of primary or secondary LVSF. However, the 3D-STI evaluating capability of left ventricular myocardial contractile function (LVMCF) in DM remains uncertain and further reports are needed.

Research motivation

To explore the application value of 3D-STI in assessing LVMCF in DM by meta-analysis.

Research objectives

To investigate the assessment of 3D-STI in estimating early left ventricular systolic dysfunction in DM by meta-analysis. 3D-STI provides a feasible and accurate new technique for clinical measurement of LVSF in left ventricular caused by DM, which might play an important role in the evaluation of cardiac function injury.

Research methods

We carried out a meta-analysis to evaluate myocardial function in patients with DM compared with controls according to myocardial strain attained by 3D-STI. We searched he PubMed, Embase, Scopus databases, and the Cochrane library from the initial accessible time to 29 April 2023. PRISMA guidelines were used. Data for meta-analysis were pooled using a random-effects model. We extracted data and used the Cochrane “Risk of bias” tool to assess methodological quality. Effect was presented as mean difference with 95% confidence interval using RevMan 5.3. The current study is the first meta-analysis to report that 3D-STI could precisely assess early left ventricular systolic dysfunction in DM.

Research results

The findings of this meta-analysis implied that there existed anomalous alterations in left ventricular myocardial mechanics in DM without a significant decrease in LVEF. In addition, 3D-STI could obtain parameters such as GRS, GLS, GAS, GCS, 3D-Strain and so on. Among them, the decrease of GLS and GAS was more obvious, which may be since the left ventricular wall is composed of three layers of myocardial fibers: The subepicardial myocardial fibers are arranged counterclockwise oblique in the direction of the left ventricular longitudinal axis, approximately circular in the middle layer of the ventricular wall, and clockwise in the longitudinal axis to the innermost layer, namely the subendocardial layer.

Research conclusions

Our data provided the first evidence for the essential role of 3D-STI in assessing the early left ventricle systolic dysfunction in DM precisely. The assessment of left ventricular strain in DM patients through 3D-STI might estimate the damage of LVSF in DM in the early stage.

Research perspectives

We believe that with the continuous improvement of computer and three-dimensional ultrasound technology, the shortcomings will be overcome, and 3D-STI is expected to become the gold standard for clinical non-invasive determination of LVSF.