Figures & data
Figure 1 Flow chart of patient enrollment and grouping. LVDD+ group: patients diagnosed with LVDD; LVDD– group: patients with normal left ventricular diastolic function.
![Figure 1 Flow chart of patient enrollment and grouping. LVDD+ group: patients diagnosed with LVDD; LVDD– group: patients with normal left ventricular diastolic function.](/cms/asset/631e2393-d5a2-4b6a-ab55-cfe724786e22/dijg_a_12168679_f0001_b.jpg)
Figure 2 The replenishment curve formed after all microbubbles within an ultrasound field are destroyed by a single ultrasound pulse. It can be described by the following function: , which is used to derive parameters A and β. A is the plateau acoustic intensity reflecting myocardial blood volume, β is the rate of rise of acoustic intensity increase reflecting MP velocity, and A×β is the slope of the tangent to the curve at the origin, representing myocardial blood flow.Citation18
![Figure 2 The replenishment curve formed after all microbubbles within an ultrasound field are destroyed by a single ultrasound pulse. It can be described by the following function: , which is used to derive parameters A and β. A is the plateau acoustic intensity reflecting myocardial blood volume, β is the rate of rise of acoustic intensity increase reflecting MP velocity, and A×β is the slope of the tangent to the curve at the origin, representing myocardial blood flow.Citation18](/cms/asset/d69f8287-86b7-40bf-88ae-6ad4c2d0c67d/dijg_a_12168679_f0002_c.jpg)
Figure 3 Quantitative MCE analysis in a T2DM patient. Apical 2-, 3-, and 4-chamber views are observed at the end-systolic frame. Five ROIs are placed in the myocardium of the apical segment. The specific positions are as follows: apical septal and lateral segments, as well as apical cap in apical 4-chamber view (A); apical inferior and anterior segments, as well as apical cap apical in 2-chamber view (B); and apical lateral and anterior segments, as well as apical cap in apical long axis view (C). A, β, and A×β in each segment are obtained and all measurements are repeated 3 times to take the average. A represents myocardial blood volume, β represents myocardial perfusion velocity, and A×β represents myocardial blood flow.
![Figure 3 Quantitative MCE analysis in a T2DM patient. Apical 2-, 3-, and 4-chamber views are observed at the end-systolic frame. Five ROIs are placed in the myocardium of the apical segment. The specific positions are as follows: apical septal and lateral segments, as well as apical cap in apical 4-chamber view (A); apical inferior and anterior segments, as well as apical cap apical in 2-chamber view (B); and apical lateral and anterior segments, as well as apical cap in apical long axis view (C). A, β, and A×β in each segment are obtained and all measurements are repeated 3 times to take the average. A represents myocardial blood volume, β represents myocardial perfusion velocity, and A×β represents myocardial blood flow.](/cms/asset/05fc9312-672f-4636-814b-f8944ab5ae16/dijg_a_12168679_f0003_c.jpg)
Table 1 Comparison of Clinical Characteristics in T2DM Patients Between LVDD– and LVDD+ Groups
Table 2 Comparison of General Echocardiographic Parameters Between LVDD– and LVDD+ Groups
Table 3 Comparison of MCE Parameters Between LVDD– and LVDD+ Groups
Figure 4 Comparison of MBF (represented by A×β) between LVDD– and LVDD+ groups. Bars represent median with interquartile 25–75. The MBF in the LVDD+ group is significantly lower than in the LVDD– group (P value < 0.05). LVDD+ group: patients diagnosed with LVDD; LVDD– group: patients with normal left ventricular diastolic function.
![Figure 4 Comparison of MBF (represented by A×β) between LVDD– and LVDD+ groups. Bars represent median with interquartile 25–75. The MBF in the LVDD+ group is significantly lower than in the LVDD– group (P value < 0.05). LVDD+ group: patients diagnosed with LVDD; LVDD– group: patients with normal left ventricular diastolic function.](/cms/asset/82ace7c0-209a-443d-9438-1bd81cb25331/dijg_a_12168679_f0004_c.jpg)
Figure 5 Bland–Altman plots for intra-observer (A) and inter-observer (B) reproducibility of MCE parameter A×β. Both show small standard deviations. A×β represents myocardial blood flow.
![Figure 5 Bland–Altman plots for intra-observer (A) and inter-observer (B) reproducibility of MCE parameter A×β. Both show small standard deviations. A×β represents myocardial blood flow.](/cms/asset/8b6f70f3-3570-477e-98ee-9b7536e80591/dijg_a_12168679_f0005_c.jpg)
Figure 6 ROC curve of MCE parameter A×β in the diagnosis of LVDD in T2DM patients. A×β represents myocardial blood flow.
![Figure 6 ROC curve of MCE parameter A×β in the diagnosis of LVDD in T2DM patients. A×β represents myocardial blood flow.](/cms/asset/94eedb6f-6ac5-4da8-8327-ec3aa52780d0/dijg_a_12168679_f0006_c.jpg)
Figure 7 Correlations of A×β with HbA1c (A) and diabetic duration (B). A×β is negatively correlated with HbA1c and diabetic duration (r = −0.226 and −0.350, both P values < 0.001).
![Figure 7 Correlations of A×β with HbA1c (A) and diabetic duration (B). A×β is negatively correlated with HbA1c and diabetic duration (r = −0.226 and −0.350, both P values < 0.001).](/cms/asset/10e964af-14a4-4a5f-a82c-cd10b2d4fe6c/dijg_a_12168679_f0007_c.jpg)