Technology is rapidly advancing in detecting subclinical heart disease at a much earlier stage. Global heart strain, better known as Left Ventricular Global Longitudinal Strain (LV-GLS) is such an example. It utilizes speckle tracking imaging of transthoracic echocardiography.
LV-GLS identifies left ventricular dysfunction at its embryo before the ejection fraction has declined, a definition of heart failure. Investigators have tested it in a variety of heart anomalies, including ischemic, atherosclerotic, viral, hypertrophic, and dilated myopathies.
Authors applied LV-GLS technology to adults with type 2 diabetes. Retrospectively, they followed about 400 diabetes patients for six years and documented their all-cause mortality.
The article defined abnormal global heart strain when LV-GLS measurement was greater than two positive standard deviations (>-17%). All-cause mortality was significantly higher, by 2.8-fold, in adults with abnormal LV-GLS versus those with normal LV-GLS.
Prospective research would need to validate these results in outcome-driven interventional randomized clinical trials. I anticipate positive results and wide-spread use of LV-GLS technology in the future.
Fortunately, we have SGLT-2 inhibitors as a unique class of medication that could potentially treat and manage patients with diabetes and abnormal heart strain.