Left ventricular function in well-controlled insulin-dependent (type I) diabetics--an echophonocardiographic study

Area of Science:

• Cardiology
• Endocrinology
• Diabetology

Background:

• Insulin-dependent (Type 1) diabetes is linked to a high prevalence of left ventricular dysfunction.
• The specific impact of metabolic control and diabetic microangiopathy on cardiac function remains unclear.

Purpose of the Study:

• To assess left ventricular function in Type 1 diabetic patients with good metabolic control.
• To determine the influence of metabolic control and microangiopathy on diastolic properties.

Main Methods:

• Echophonocardiography was used to evaluate 50 Type 1 diabetic patients and 50 age/sex-matched controls.
• Patients had a mean age of 26 years and a mean Hemoglobin A1c of 8.8%.

Main Results:

• No significant differences were observed in left ventricular internal diameters, wall thickness, or systolic function (PEP/LVET ratio, FS) between groups.
• A slight but significant prolongation of the isovolumetric relaxation period was found in diabetic subjects.
• This prolongation was independent of metabolic control or microangiopathy and correlated with age in diabetics.

Conclusions:

• Type 1 diabetes, even with fair metabolic control, may lead to subtle alterations in myocardial diastolic properties.
• Biochemical changes related to diabetes, not fully normalized, might impact cardiac diastolic function.
• Early diastolic dysfunction, indicated by prolonged isovolumetric relaxation, may be an early sign in Type 1 diabetes.