Quantitative analysis of the magnitude and time delay of cyclic variation of
myocardial backscatter from asymptomatic type 2 diabetes mellitus subjects.
Authors Gibson AA, Schaffer JE, Peterson LR, Bilhorn KR, Robert KM, Haider TA, Farmer
MS, Holland MR, Miller JG
Submitted By Jean Schaffer on 3/31/2010
Status Published
Journal Ultrasound in medicine & biology
Year 2009
Date Published 9/1/2009
Volume : Pages 35 : 1458 - 1467
PubMed Reference 19616360
Abstract Early detection of diabetic patients at high risk for developing diabetic
cardiomyopathy may permit effective intervention. The goal of this work is to
determine whether measurements of the magnitude and time delay of cyclic
variation of myocardial backscatter, individually and in combination, can be
used to discriminate between subgroups of individuals including normal controls
and asymptomatic type 2 diabetes subjects. Two-dimensional parasternal long-axis
echocardiographic images of 104 type 2 diabetic patients and 44 normal
volunteers were acquired. Cyclic variation data were produced by measuring the
mean myocardial backscatter level within a region-of-interest in the posterior
wall, and characterized in terms of the magnitude and normalized time delay. The
cyclic variation parameters were analyzed using Bayes classification and a
nonparametric estimate of the area under the receiver operating characteristic
(ROC) curve to illustrate the relative effectiveness of using one or two
features to segregate subgroups of individuals. The subjects were grouped based
on glycated hemoglobin (HbA1c), the homeostasis model assessment for insulin
resistance (HOMA-IR) and the ratio of triglyceride to high-density lipoprotein
cholesterol (TG/HDL-C). Analyses comparing the cyclic variation measurements of
subjects in the highest and lowest quartiles of HbA1c, HOMA-IR and TG/HDL-C
showed substantial differences in the mean magnitude and normalized time delay
of cyclic variation. Results show that analyses of the cyclic variation of
backscatter in young asymptomatic type 2 diabetics may be an early indicator for
the development of diabetic cardiomyopathy.

Investigators with authorship
Jean SchafferWashington University in St Louis


Hba-a1hemoglobin alpha, adult chain 1