Cardio-renal dysfunction in prediabetes and early type 2 diabetes: insights from myocardial strain and renal Doppler assessment.

Participants with prediabetes and early T2DM showed early alterations in left ventricular relaxation/filling indices compared with healthy controls.

• Cross-sectional study of 180 participants: 60 prediabetes, 60 newly diagnosed T2DM (≤2 years), and 60 age- and sex-matched healthy controls.
• Conventional echocardiography was used to assess LV diastolic function and filling indices.
• Alterations were present despite preserved conventional cardiac function.

Left atrial strain was reduced in the prediabetes and T2DM groups relative to controls.

• LA mechanics were assessed with two-dimensional speckle-tracking echocardiography.
• Reduced LA strain was observed in both dysglycemic groups compared with controls.

LV global longitudinal strain (GLS) became progressively less negative across the dysglycemic groups, indicating reduced longitudinal myocardial deformation, while LV ejection fraction was only modestly lower.

• The GLS trend across groups was reported as p < 0.001.
• The abstract describes LVEF as 'modestly lower' in the dysglycemic groups.
• The GLS pattern is described as 'consistent with reduced longitudinal myocardial deformation'.

Renal resistive index (RRI) and pulsatility index (PI) were significantly increased in the prediabetes and T2DM groups.

• Renal vascular resistance was assessed with Doppler-derived RRI and PI.
• Increases were present in the dysglycemic groups relative to controls.
• The abnormalities occurred despite preserved conventional renal function.

RRI correlated positively with E/e', linking higher renal vascular resistance with higher estimated LV filling pressure.

• Correlation was r = 0.440, p < 0.001.
• E/e' is an echocardiographic estimate of LV filling pressure.

Prediabetes and early T2DM were associated with subclinical cardiac and renal abnormalities even though conventional cardiac and renal function was preserved.

• Glycemic status and albuminuria were evaluated using fasting glucose, OGTT, HbA1c, and urine albumin-to-creatinine ratio.
• Myocardial strain and renal Doppler measures may provide complementary phenotypic information.

The authors state that prospective validation is required before myocardial strain and renal Doppler measures are used in routine clinical practice.

• The study was cross-sectional, so it cannot establish temporal or causal relationships.