Assessment of Echocardiographic Parameters among Hypertensive and Diabetic Sudanese Patients

Abstract

The aims of this hospital-based study were to assess the 2D echocardiographic parameters in diabetic and hypertensive Sudanese patients and to correlate the findings with patients’ age and body mass index (BMI)as well as to establish new equations to be used for prediction and early detection of changes helping for early diagnosis. This study was carried out at Elshaab University Hospital- echocardiographic unit - Khartoum - Sudan, during the period extended from August 2016 to August 2019. 116 were diabetic and 101 were hypertensive and 100 subjects were considered as control group. Mean Ages was 44.5 ±11,1, 57.3 ±13.3, and 57.2± 13.1 and BMI was 24.7 ±8.5, 27.1 ±6.4, and 28.1 ±10.7, respectively for normal individuals, hypertensive patients, and diabetic patients. Pregnant ladies, patients with genetic disorders, patients with cardiac anomalies or any abnormalities were excluded. A well-designed data sheet was used ,the study variables were age , BMI and 2D echocardiographic parameters including Interventricular septal diameter (IVS), Left ventricular internal diameter in diastole(LVIDd), Left ventricular internal diameter in systole(LVIDs), Left ventricular posterior wall diameter in diastole(LVPWDd), Left ventricular posterior wall diameter in systole(LVPWDs),Left ventricular end diastolic volume (LVEDV), Left ventricular end systolic volume(LVESV), Left ventricular ejection fraction(LVEF), Left ventricular fraction shorten(LVFS), Left ventricular mass (LVM), Aortic root Diameter (AOD), Left Atrial diameters in systole (LADs), Left Atrial diameters in diastole (LADd), left atrial diameter to aortic diameter (LAD/AOD%). The data were statistically analyzed using IBM SPSS Statistics version 25. In addition to linear discrimination analysis. Machines used were: (XARIO200, SAMSUNG, MYLAB50XVISION CARDIOVASCULA) using high frequency applied Parasternal long and short-axis and apical window views (Two and four chambers) views. In hypertensive patients results revealed that, the mean values of (LVPWDs) and the (LAD/AOD%) were increased with age (p-values =0.036 , 0.008), and the systolic blood pressure and (LVPWDd) were decreased with age (p-value= - 0.02 ,- 0.08). The increasing in (LVEF), (LVFS), (LVPWDs), and (AOD) (p-values = 0.013, 0.006, 0.015, and 0.002, respectively was associated with Age. However, the (LVPW) and (IVSD) were increased significantly with BMI (p-values = 0.015 and 0.021). There were significant associations between left ventricular volumes (LVED and LVES) with duration of hypertension (p-value= 0.000,0.000).In diabetic patients results showed an increasing in (LVIDs) and it was significantly correlated with the increasing in BMI (p-value = -0.012).there was a correlation between blood sugar value and (AOD) (p-value = 0.026).Ejection fractionwas found to be declined in hypertensive and diabetic patients compared to normal values but remained within the normal range based on standard measurements, which should be greater than 55%. Using a linear discriminates function, New equations substitutethe 2D echocardiography parameter resultsas normal, hypertensive, or diabetic by eloquent the patients age and height, Normal = (Age × 0.34) + (Height × 0.71) + (EDV × -0.01) + (LVIDS × 4.88) + (ESV × 0.04) + (EF × .02) + (FS × 0.74) + (LVM × -0.01) -84.09. Hypertensive = (Age × 0.48) + (Height × 0.75) + (EDV × -0.02) + (LVIDS × 7.87) + (ESV × 0.09) + (EF × 0.05) + (FS × 1.24) + (LVM × -0.04) -134.36 Diabetic = (Age × 0.41) + (Height × 0.75) + (EDV × 0.01) + (LVIDS × 5.35) + (ESV × 0.03) + (EF × 0.02) + (FS × 0.74) + (LVM × 0.01) -100.22.). Equationswere recommended to be used to determine whether a patient was normal, hypertensive, or diabetic in addition to highlighting the impact of hypertension and diabetics on some key echocardiographic parameters related to Sudanese people'sof inimitable physical characteristics. These findings might help in detection of changes helping for early diagnosis.