A statistical study on left ventricular peak filling rate in diabetes
Insights
Peak filling rate (PFR) in diabetic patients is mainly determined by age and left ventricular function, not diabetes duration. Young diabetics without angina are unlikely to have significant PFR impairment.
Area of Science:
- Cardiology
- Diabetology
- Medical Imaging
Background:
- Non-invasive cardiac function evaluation is crucial in diabetes.
- Radionuclide angiocardiography is an accepted diagnostic tool.
- Determinants of peak filling rate (PFR) in diabetes require clarification.
Purpose of the Study:
- To evaluate the determinants of PFR in diabetic patients.
- To understand the clinical implications of PFR changes in diabetes.
Main Methods:
- Utilized a pattern recognition approach.
- Applied principal component analysis and hierarchical cluster analysis.
- Studied 48 non-selected diabetic patients.
Main Results:
- PFR is inversely dependent on age, the primary determinant when systolic function is preserved.
- PFR is influenced by left ventricular dimensions, angina, and wall motion.
- Diabetes duration did not significantly affect PFR.
Conclusions:
- Young diabetic patients without angina are unlikely to have significant PFR impairment.
- PFR decrease in asymptomatic, middle-aged diabetics with normal systolic function may be age-related, not necessarily latent ventricular dysfunction.
Abstract:
The importance of non-invasive evaluation of cardiac function in diabetes is well known and radionuclide angiocardiography has become an accepted diagnostic procedure. While the pathophysiological interpretation of systolic parameters is clear, the meaning and determinants of peak filling rate (PFR) remain rather speculative. In the present study, a "pattern recognition" approach, including principal component analysis and hierarchical cluster analysis, has been adopted in order to evaluate the determinants of PFR in a series of 48 non-selected diabetic patients. The results of the study show that: PFR is inversely dependent on age which is its main determinant when systolic function is preserved; PFR is inversely dependent on combined effects of left ventricular dimensions, angina and wall motion; and the duration of diabetes in itself does not influence PFR. These results lead to the following clinically relevant conclusions: (a) It is unlikely that a young diabetic patient without anginal symptoms will have a significant PFR impairment even if the diabetes has been present for a long time. If such impairment is however present, ventricular latent dysfunction is likely to be the cause even if systolic parameters are still normal; (b) A decrease of PFR in a middle-aged diabetic patient without symptoms and with normal systolic function cannot be equated with latent ventricular dysfunction as it may represent only an age-related physiological change without special diagnostic meaning.
