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[Cardiac anatomical and functional changes in a group of young type I diabetics with microangiopathy]
1Cátedra de Patología y Clínicas Médicas, Facultad de Medicina de Murcia.
Insights
Diabetic hearts show structural and diastolic dysfunction, not systolic, linked to diabetes duration. Microvascular complications may also contribute to these cardiac changes in type 1 diabetes.
Area of Science:
- Cardiology
- Diabetology
- Medical Imaging
Background:
- Conflicting data exists on cardiac function alterations in diabetics without other pathologies.
- This study focuses on anatomical and functional cardiac changes in relation to diabetes duration and control.
Purpose of the Study:
- To analyze anatomical and functional cardiac changes in type 1 diabetic patients.
- To correlate these changes with diabetes duration and control, specifically in the absence of other pathologies.
Main Methods:
- Studied 54 type 1 diabetics (mean age 33.5 years) and 25 healthy controls, rigorously selected for insulin use and microangiopathy.
- Utilized M-mode, bidimensional echocardiography, and Doppler-echo studies to assess cardiac structure, systolic, and diastolic function parameters.
Main Results:
- Diabetics exhibited significant differences in posterior wall and septum thickness compared to controls.
- No significant differences in systolic function were observed; however, 70% of patients showed diastolic alterations.
- Diastolic alterations correlated significantly with diabetes duration; autonomic dysfunction did not impact results.
Conclusions:
- Selected diabetic patients present structural and diastolic cardiac alterations attributable to diabetes duration and potentially microangiopathy.
- Findings suggest diabetes itself, over time, leads to specific cardiac functional and structural changes.
Background:
There are conflicting data concerning the alteration of cardiac function in diabetics without another type of accompanying pathology. Therefore this study was designed with the aim to analyze the anatomical and functional changes and relate them with the time and control of diabetes.
Methods:
Fifty-four type I diabetics with a mean age of 33.5 years and 25 healthy controls paired by age and sex were studied. The patients were rigourously selected excluding any disease or treatment other than insulin and the presence of demonstrated microangiopathy was required. M-mode and bidimensional echocardiographic studies were carried out in 46 patients to calculate thickness, cavity dimension and systolic function rates. Doppler-echo studies analyzing 9 parameters of diastolic function were performed in all the 54 patients studied.
Results:
The results obtained demonstrated significant differences in the thickness of the posterior wall and the septum in the diabetics in comparison with the normal subjects. No differences were observed in the parameters of systolic function with the diastolic parameters being significant. Considered globally 41% of the patients demonstrated structural alterations, 4% systolic and 70% diastolic. The only significant correlation was established between the diastolic alteration and the time of evolution of the diabetes. The autonomic alteration which some patients presented did not vary the results obtained.
Conclusions:
In this group of selected diabetic structural and cardiac diastolic alterations appeared being attributed only to the diabetes itself in relation to the length of time of the same and possibly to the microangiopathy.