[The influence of glycemia on the left ventricular diastolic function in patients with arterial hypertension]
Suzana Milutinović1, Radovan Karadzić
1Poliklinika "Varnava", Nis.
Insights
Diabetic patients with arterial hypertension show impaired left ventricular diastolic function. Higher glycemia levels correlate with longer deceleration times and reduced early-stage ventricular filling velocities.
Area of Science:
- Cardiology
- Diabetology
- Echocardiography
Context:
- Arterial hypertension impacts left ventricular diastolic function.
- Diabetic cardiomyopathy mechanisms are debated, with potential roles beyond hypertension and atherosclerosis.
- Glycemia's specific effect on diastolic function in hypertensive patients requires investigation.
Purpose:
- To investigate the effect of glycemia on left ventricular diastolic function in patients with arterial hypertension.
- To compare diastolic function parameters between hypertensive patients with and without diabetes mellitus.
Summary:
- Sixty hypertensive patients (30 with diabetes) underwent Doppler echocardiography.
- Hypertensive patients with diabetes exhibited higher obesity, glycemia, and left atrial volume.
- Significant differences in diastolic function included longer deceleration time, lower early diastolic filling velocity, and lower early/late filling ratio in diabetic patients.
Impact:
- Demonstrates significant alterations in diastolic function parameters in hypertensive patients with diabetes mellitus.
- Highlights the influence of glycemia on cardiac diastolic function.
- Provides echocardiographic evidence of diabetic cardiomyopathy in hypertensive individuals.
Introduction:
Arterial hypertension is a disease which has influence on the left ventricular diastolic function. It has been suggested that impairment of the left ventricular diastolic function in patients with diabetes mellitus is due to arterial hypertension and diffuse peripherial and coronary atherosclerosis which appear early in diabetic patients. Now, however, it is thought, that other mechanisms are responsable for the development of diabetic cardiomyopathy. The aim of the study was to investigate the effect of glycemia on the left ventricular diastolic function in patients with arterial hypertension.
Methods:
The study included 60 patients with arterial hypertension: 30 (50.00%) patients with diabetes mellitus and 30 (50.00%) without diabetes mellitus. The parameters of diastolic function were measured by the pulsed Doppler echocardiographic technique. Isovolumetric relaxation time, deceleration time, maximum velocity of the early stage of ventricular filling, maximum velocity of the late stage of ventricular filling and the early/late stage of ventricular filling ratio were used to assess the diastolic function.
Results:
The patients with arterial hypertension and diabetes mellitus compared to the patients with arterial hypertension without diabetes mellitus were significantly obese (p < 0.001), had significantly higher glycemia (p < 0.0001) and left atrial volume (p < 0.05). The patients with arterial hypertension and diabetes mellitus compared to the patients with arterial hypertension without diabetes mellitus had significantlly: longer deceleration time (p < 0.05), lower velocity of early stage of ventricular filling (p < 0.05) and lower early/late stage of ventricular filling ratio (p < 0.01).
Conclusion:
Diastolic function parameters of patients with diabetes mellitus are significantly changed: deceleration time is longer, early stage of ventricular filling and early/late ventricular filling ratio are lower.
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