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[Cardiac function (angiocardioscintigraphic evaluation) and plasma catecholamine levels in non-insulin-dependent
S Ferraro1, G Maddalena, C Codella
1Cattedra di Cardiologia, II Facoltà di Medicina e Chirurgia, Università degli Studi, Napoli.
Insights
Diabetic patients exhibit impaired cardiac function, with lower ejection fraction and stroke volume at rest and during exertion. This study highlights subclinical cardiac dysfunction in type II diabetes mellitus, even without complications.
Area of Science:
- Cardiology
- Endocrinology
- Nuclear Medicine
Background:
- Diabetic patients have a higher risk of cardiac mortality and heart failure.
- Subclinical cardiac dysfunction may precede overt symptoms in diabetes.
Purpose of the Study:
- To assess cardiac function in type II diabetes mellitus patients using radionuclide ventriculography.
- To compare cardiac performance at rest and during effort between diabetics and healthy individuals.
Main Methods:
- Radionuclide ventriculography with technetium 99m was performed on 20 type II diabetics and 13 controls.
- Cardiac indices including ejection fraction (EF), stroke volume, and cardiac output were measured at rest and during exercise.
- Coronary artery disease (CAD) was excluded in diabetics via maximal effort ECG.
Main Results:
- Diabetic patients showed significantly lower resting stroke volume, peak filling rate, cardiac output, and ejection fraction (EF) compared to controls.
- Systemic vascular resistances (SVR) were elevated in diabetics (p < 0.01).
- While EF increased with effort in most diabetics, 30% demonstrated no improvement in EF during exertion.
Conclusions:
- Type II diabetes mellitus is associated with impaired cardiac function, including reduced systolic performance and elevated systemic vascular resistance.
- Subclinical cardiac dysfunction exists in well-controlled diabetics without complications.
- Radionuclide ventriculography is effective in detecting early cardiac abnormalities in diabetic patients.
Abstract:
Cardiac mortality is more frequent in diabetic patients than in normal subjects and particularly heart failure occurs 4-6 times more frequently in these patients than in normals also excluding diabetics with coronary artery disease (CAD). To study cardiac function, 20 patients with type II diabetes mellitus (11 M and 9 F, mean age 48 +/- 9 years), and 13 normal subjects (6 M and 7 F, mean age 48 +/- 13 years), were submitted to radionuclide ventriculography with technetium 99m to evaluate some indices of cardiac function at rest and during effort. The diabetic patients were on good metabolic control testified by a satisfactory fasting and post prandial glycaemia, absence of glycosuria in the last 3 monthly controls and a normal value of glycosylate haemoglobin; they had no vascular or neurological complications; CAD was excluded submitting these patients to a maximal effort ECG on an ergometer. The normal subjects were comparable to diabetic patients for age, sex, mean arterial pressure, body mass index and body surface area. At rest, stroke volume, peak filling rate, cardiac output, ejection fraction (EF), were significantly lower in diabetic patients than in normal subjects. Systemic vascular resistances (SVR) were higher in diabetics than in normal subjects (p less than 0.01). Mean EF during effort increased in both normals and diabetics but 30% of diabetic patients showed no increase in EF during effort (less than 5%). Preload, represented by end-diastolic volume or blood volume, did not differ in the 2 groups.(ABSTRACT TRUNCATED AT 250 WORDS)