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Left ventricular diastolic function in type 2 diabetes mellitus: prevalence and association with myocardial and

Mikael Kjaer Poulsen1, Jan Erik Henriksen, Jordi Dahl

  • 1Departments of Endocrinology, Nuclear Medicine, and Cardiology, Odense University Hospital, Kløvervaenget 6, Odense, Denmark. mikael.kjaer.poulsen@ouh.regionsyddanmark.dk

Circulation. Cardiovascular Imaging
|October 23, 2009
PubMed

Insights

Type 2 diabetes patients often have abnormal heart filling. Myocardial perfusion issues, not vascular changes, are linked to this diastolic dysfunction and atrial enlargement.

Area of Science:

  • Cardiology
  • Endocrinology
  • Medical Imaging

Background:

  • Type 2 diabetes mellitus is a known risk factor for congestive heart failure.
  • The precise mechanisms linking type 2 diabetes to heart failure remain unclear.
  • This study investigates left ventricular dysfunction in diabetic patients concerning vascular function and myocardial perfusion.

Purpose of the Study:

  • To determine the prevalence of left ventricular (LV) systolic and diastolic dysfunction in patients with type 2 diabetes mellitus.
  • To explore the relationship between LV dysfunction, vascular function, and myocardial perfusion in this patient group.

Main Methods:

  • A prospective observational study involving 305 patients with type 2 diabetes mellitus.
  • Echocardiography was used to assess LV systolic and diastolic function.
  • Noninvasive methods estimated vascular function (pulse pressure, arterial compliance, valvulo-arterial impedance).
  • Myocardial perfusion scintigraphy assessed for myocardial ischemia.

Main Results:

  • 40% of patients exhibited LV diastolic dysfunction, and 32% had an enlarged left atrial volume index (>32 mL/m²).
  • Myocardial ischemia was more prevalent in patients with severe diastolic dysfunction and elevated left atrial volume index (P<0.002).
  • Myocardial perfusion scintigraphy scores and valvulo-arterial impedance predicted diastolic dysfunction and left atrial dilation in multivariable analysis.

Conclusions:

  • Abnormal left ventricular filling is strongly associated with impaired myocardial perfusion.
  • The link between left ventricular filling abnormalities and vascular function is less significant.
  • These findings highlight the importance of assessing myocardial perfusion in diabetic patients with heart dysfunction.
Abstract

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