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003			EG-GICUC
005			20260311115932.0
008			260303s2025 ua a|||frm||| 000 0 eng d
040			_aEG-GICUC _beng _cEG-GICUC _dEG-GICUC _erda
041	0		_aeng _beng _bara
049			_aDeposit
082	0	4	_a616.462061
092			_a616.462061 _221
097			_aPh.D
099			_aCai01.11.18.Ph.D.2025.Ah.A
100	0		_aAhmed Atef Mohammed Elsayed Metwally, _epreparation.
245	1	0	_aAssessment of left ventricular function and its association with intrarenal arterial resistance in pre-diabetic and recently diagnosed uncomplicated type 2 diabetic patients / _cby Ahmed Atef Mohammed Elsayed Metwally ; Supervised Prof. Dr. Hemmat Elewa El- Haddad, Prof. Dr. Ahmed Mohammed Fayed, Prof. Dr. Moataz Fathy Mohammed, Prof. Dr. Heba Moustafa Eldeeb.
246	1	5	_aتقييم وظيفة البطين الأيسر وارتباطها بمقاومة الشرايين داخل الكلى لدى مرضى ما قبل السكري و مرضي السكري من النوع الثاني الغير مصحوب بمضاعفات و الذين تم تشخيصهم حديثا
264		0	_c2025.
300			_a158 pages : _billustrations ; _c25 cm. + _eCD.
336			_atext _2rda content
337			_aUnmediated _2rdamedia
338			_avolume _2rdacarrier
502			_aThesis (Ph.D)-Cairo University, 2025.
504			_aBibliography: pages 126 -158.
520		3	_aBackground: Early dysglycemia, including pre-diabetes and early Type 2 Diabetes Mellitus (T2DM), triggers oxidative stress, causing endothelial dysfunction, intra- renal arterial stiffness, and subclinical cardiac issues such as myocardial ischemia and fibrosis, even without epicardial artery disease. Advanced imaging techniques can detect these subtle changes. Aim: To evaluate left ventricular (LV) and left atrial (LA) function using Tissue Doppler Imaging (TDI) and 2D Speckle Tracking Echocardiography (2D STE), and their relationship with intra-renal artery compliance assessed by renal power Doppler ultrasonography in early dysglycemia. Mehtods: This observational case-control study, conducted at Kasralainy Hospitals from December 2023 to February 2025, enrolled 180 participants: 60 recently diagnosed T2DM patients (≤2 years), 60 pre-diabetic individuals (per ADA 2024 criteria), and 60 healthy controls, aged 18–50, normotensive, and matched for age, gender, BMI, and waist circumference. Assessments included glycemic profile (fasting blood sugar, 75g OGTT, HbA1c), lipid profile, urinary albumin-to-creatinine ratio (ACR), echocardiographic parameters via 2D STE, and renal arterial indices, particularly Renal Resistance Index (RI), via renal power Doppler ultrasound. Results: Compared to controls, T2DM and pre-diabetic groups had significantly higher eGFR, total cholesterol, triglycerides, LDL, and diastolic dysfunction (grades I and II) (P<0.05). Despite normal ranges, both groups showed impaired diastolic indices (higher E/e, lower MV E/A ratio, lower LA strain) and systolic indices (lower ejection fraction, global longitudinal strain [GLS]) (P<0.05). Renal RI was significantly elevated in both groups, with T2DM showing higher values than pre- diabetics (P<0.05). Glycemic markers and ACR correlated positively with E/e and RI and negatively with LA strain and GLS (P<0.05). RI positively correlated with E/e and negatively with septal S, indicating a link between diastolic/systolic impairment and renal arterial resistance. Conclusion: Despite normal range, Compared to controls, early T2DM & Pre- diabetic groups showed significantly impaired left atrial & ventricular diastolic & systolic indices paralleled with increased intrarenal arterial resistance. Worsening of these cardiac and renal indices correlate with dysglycemic markers & Albuminuria; hence early T2DM &pre-diabetes are associated with subclinical LV, LA dysfunction and renal arterial stiffness. So, early 2D STE and Renal artery power Doppler screening may identify at-risk individuals, enabling timely intervention to prevent cardiac & renal complications.
520		3	_aهدفت هذه الدراسة إلى تقييم وظائف البطين الأيسر والأذين الأيسر باستخدام تخطيط صدى القلب بتتبع النقاط ثنائي الأبعاد وارتباطها بطواعية الشرايين داخل الكلى لدى ستين فردًا في مرحلة ما قبل السكري، وستين فردًا تم تشخيصهم حديثًا بمرض السكري من النوع الثاني (مدة المرض سنتان أو أقل)، وستين فردًا أصحاء متطابقين في العمر والجنس، تتراوح أعمارهم بين ثمانية عشر إلى خمسين عامًا، وهم غير مصابين بارتفاع ضغط الدم وبدون أمراض مصاحبة، ومتطابقين في مؤشر كتلة الجسم ومحيط الخصر.
530			_aIssues also as CD.
546			_aText in English and abstract in Arabic & English.
650		0	_aDiabetes
650		0	_aداء السكري
653		1	_aPrediabetes _aT2DM _aLV dysfunction _arenal stiffness _a2D STE _aGLS _arenal Doppler _aRI
700	0		_aHemmat Elewa El- Haddad _ethesis advisor.
700	0		_aAhmed Mohammed Fayed _ethesis advisor.
700	0		_aMoataz Fathy Mohammed _ethesis advisor.
700	0		_aHeba Moustafa Eldeeb _ethesis advisor.
900			_b01-01-2025 _cHemmat Elewa El- Haddad _cAhmed Mohammed Fayed _cMoataz Fathy Mohammed _cHeba Moustafa Eldeeb _UCairo University _FFaculty of Medicine _DDepartment of Internal Medicine
905			_aShimaa _eEman Ghareb
942			_2ddc _cTH _e21 _n0
999			_c178856