When sweet becomes too sweet: Left ventricular longitudinal strain in focus

Left ventricular (LV) remodeling in patients with diabetes mellitus has been recognized since a long time (1, 2). However, the influence of insulin resistance on cardiac remodeling has not been sufficiently investigated (3). Our study group showed that metabolic syndrome and prediabetes, conditions based on insulin resistance, were associated with LV functional and mechanical changes (4, 5). Akavan-Khaleghi et al. (6) in this issue of the journal title provided a new piece of information regarding the influence of insulin resistance on LV longitudinal deformation. The authors reported no difference in LV global longitudinal strain (GLS) and systolic and diastolic strain rates between participants with glycated hemoglobin (HbA1c) level <5.7% and 5.7%–6.4% (6).