Cardio-renal dysfunction in prediabetes and early type 2 diabetes: insights from myocardial strain and renal Doppler assessment.
5 affiliations
- 1Endocrinology Unit, Internal Medicine Department, Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt.
- 2Nephrology Unit, Internal Medicine Department, Kasr Alainy School of Medicine, Cairo University, Cairo , Egypt. [email protected].
- 3Cairo University Hospitals, Al-Saray St., El-Maniel, Cairo, 11562, Egypt. [email protected].
- 4Nephrology Unit, Internal Medicine Department, Kasr Alainy School of Medicine, Cairo University, Cairo , Egypt.
- 5Cardiology Department, Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt.
Abstract
Background
Prediabetes and early type 2 diabetes mellitus (T2DM) may be accompanied by subclinical cardiac and renal injury before overt disease appears. This study evaluated early cardio-renal dysfunction in prediabetes and early T2DM using myocardial strain imaging and renal Doppler assessment.Methods
This cross-sectional study included 180 participants: 60 with prediabetes, 60 with newly diagnosed T2DM (≤ 2 years), and 60 age- and sex-matched healthy controls. Conventional echocardiography and two-dimensional speckle-tracking echocardiography were used to assess left ventricular (LV) function and left atrial (LA) mechanics. Renal vascular resistance was assessed using the Doppler-derived renal resistive index (RRI) and pulsatility index (PI). Glycemic status and albuminuria were evaluated using fasting glucose, oral glucose tolerance testing, HbA1c, and urine albumin-to-creatinine ratio.Results
Compared with controls, participants with prediabetes and T2DM showed early alterations in LV relaxation/filling indices and reduced LA strain. LV ejection fraction was modestly lower, while GLS became progressively less negative across the dysglycemic groups (p < 0.001), consistent with reduced longitudinal myocardial deformation. Renal resistive index (RRI) and pulsatility index (PI) were significantly increased in the dysglycemic groups. RRI correlated positively with E/e', linking higher renal vascular resistance with higher estimated LV filling pressure (r = 0.440, p < 0.001).Conclusions
Prediabetes and early T2DM were associated with subclinical abnormalities in myocardial mechanics and renal vascular indices despite preserved conventional cardiac and renal function. Myocardial strain and renal Doppler measures may provide complementary phenotypic information, but prospective validation is required before routine clinical application.
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BibTeX
@article{atef2026cardiorenal,
title = {{Cardio-renal dysfunction in prediabetes and early type 2 diabetes: insights from myocardial strain and renal Doppler assessment.}},
author = {Ahmed Atef and Ahmed Fayed and Hemmat El-Haddad and Moataz Fathy and Heba El Deeb},
journal = {BMC cardiovascular disorders},
year = {2026},
month = oct,
doi = {10.1186/s12872-026-06661-4},
url = {https://europepmc.org/article/MED/42902150},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Cardio-renal dysfunction in prediabetes and early type 2 diabetes: insights from myocardial strain and renal Doppler assessment.
AU - Ahmed Atef
AU - Ahmed Fayed
AU - Hemmat El-Haddad
AU - Moataz Fathy
AU - Heba El Deeb
PY - 2026
DA - 2026/10/20
JO - BMC cardiovascular disorders
DO - 10.1186/s12872-026-06661-4
UR - https://europepmc.org/article/MED/42902150
AB - Background Prediabetes and early type 2 diabetes mellitus (T2DM) may be accompanied by subclinical cardiac and renal injury before overt disease appears. This study evaluated early cardio-renal dysfunction in prediabetes and early T2DM using myocardial strain imaging and renal Doppler assessment.Methods This cross-sectional study included 180 participants: 60 with prediabetes, 60 with newly diagnosed T2DM (≤ 2 years), and 60 age- and sex-matched healthy controls. Conventional echocardiography and two-dimensional speckle-tracking echocardiography were used to assess left ventricular (LV) function and left atrial (LA) mechanics. Renal vascular resistance was assessed using the Doppler-derived renal resistive index (RRI) and pulsatility index (PI). Glycemic status and albuminuria were evaluated using fasting glucose, oral glucose tolerance testing, HbA1c, and urine albumin-to-creatinine ratio.Results Compared with controls, participants with prediabetes and T2DM showed early alterations in LV relaxation/filling indices and reduced LA strain. LV ejection fraction was modestly lower, while GLS became progressively less negative across the dysglycemic groups (p < 0.001), consistent with reduced longitudinal myocardial deformation. Renal resistive index (RRI) and pulsatility index (PI) were significantly increased in the dysglycemic groups. RRI correlated positively with E/e', linking higher renal vascular resistance with higher estimated LV filling pressure (r = 0.440, p < 0.001).Conclusions Prediabetes and early T2DM were associated with subclinical abnormalities in myocardial mechanics and renal vascular indices despite preserved conventional cardiac and renal function. Myocardial strain and renal Doppler measures may provide complementary phenotypic information, but prospective validation is required before routine clinical application.
SN - 1471-2261
ER -