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Asymptomatic diabetic cardiomyopathy: a noninvasive study.

J R Attali1, R N Sachs, P Valensi

  • 1Department of Diabetology, Hôpital Avicenne, Bobigny, France.

Diabetes Research and Clinical Practice
|February 19, 1988
PubMed
Summary

Diabetic patients show early left ventricular (LV) dysfunction, including impaired relaxation and contractility, even without heart disease. This suggests a metabolic cause, not microangiopathy, in asymptomatic individuals.

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Area of Science:

  • Cardiology
  • Diabetology
  • Biomedical Engineering

Background:

  • Diabetes mellitus is a global health concern.
  • Diabetic patients are at increased risk for cardiovascular complications.
  • Early detection of cardiac dysfunction in diabetes is crucial.

Purpose of the Study:

  • To investigate left ventricular (LV) function in asymptomatic diabetic patients.
  • To differentiate diabetic cardiomyopathy from other cardiac conditions.
  • To identify early markers of LV dysfunction in diabetes.

Main Methods:

  • Noninvasive assessment of LV function in 49 diabetic patients and 32 controls.
  • Utilized M-mode echocardiography, phonomechanography, and radionuclide angiocardiography.
  • Confirmed absence of ischemic heart disease via ECG and thallium-201 scintigraphy.

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Main Results:

  • Diabetic patients exhibited prolonged isovolumetric relaxation time (IVRT) and reduced E-F slope, indicating increased myocardial stiffness and impaired LV compliance.
  • An increased Weissler index (pre-ejection period/LV ejection time) suggested impaired myocardial contractility.
  • These abnormalities were present early in diabetes, often within 5 years, and unrelated to complications, sex, or age.
  • No significant differences were observed in LV dimensions, wall thickness, or ejection fraction between groups.

Conclusions:

  • Diabetes is associated with specific, early-onset left ventricular (LV) dysfunction, independent of ischemic heart disease or hypertension.
  • Metabolic factors, rather than microangiopathy, are likely involved in this early, asymptomatic LV abnormality.
  • Findings highlight the need for monitoring cardiac function in diabetic patients from diagnosis.