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[Afterload changes in diabetic dysautonomia evaluated using echocardiography].

A Salvaggio, M Periti, G Quaglia

    Cardiologia (Rome, Italy)
    |September 1, 1989
    PubMed
    Summary

    Diabetic patients with autonomic nervous system failure exhibit altered cardiac afterload, indicated by reduced stress indexes. These cardiovascular changes, linked to autonomic dysfunction, are detectable in diabetic individuals.

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    Area of Science:

    • Cardiology
    • Diabetology
    • Autonomic Nervous System Physiology

    Context:

    • Diabetes mellitus is associated with autonomic nervous system dysfunction.
    • Autonomic neuropathy can lead to cardiovascular complications.
    • Echocardiography is a key tool for assessing cardiac structure and function.

    Purpose:

    • To investigate echocardiographic morpho-functional alterations in diabetic males with and without autonomic nervous system failure.
    • To compare cardiac afterload indexes between diabetic groups with varying degrees of autonomic dysfunction.
    • To explore the relationship between noradrenaline levels, peripheral resistance, and cardiovascular stress in diabetic patients.

    Summary:

    • Thirty-four male diabetic subjects were categorized into groups based on autonomic nervous system function tests (deep breathing, Valsalva maneuver, postural changes).

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  • Subjects with orthosympathetic failure showed significantly lower parietal systolic stress (PSS) and end-isovolumetric systolic stress (EISS) compared to controls.
  • In the orthosympathetic failure group, higher noradrenaline levels correlated with increased blood pressure and stress indexes, suggesting altered peripheral resistance.

    • Impact:

    • Echocardiographic parameters, specifically stress index variations reflecting afterload modifications, can serve as observable cardiovascular signs of autonomic failure in diabetic patients.
    • Findings highlight the importance of assessing autonomic function in diabetic individuals to predict and manage cardiovascular risks.
    • This study contributes to understanding the complex interplay between diabetes, autonomic dysfunction, and cardiac hemodynamics.