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[Preclinical left ventricular diastolic dysfunction in insulin-dependent diabetes]
E Cecchi1, F Pomari, G Brusasco
1Divisione di Cardiologia, Ospedale Maria Vittoria di Torino.
Giornale Italiano Di Cardiologia
|July 1, 1994
Summary
Diabetic insulin-dependent patients (IDDM) show early signs of diastolic dysfunction, even without complications. This cardiac issue worsens with the presence of microangiopathy in young, recently diagnosed individuals.
Area of Science:
- Cardiology
- Diabetology
- Echocardiography
Background:
- Isolated left ventricular diastolic dysfunction is observed in diabetic insulin-dependent patients (IDDM).
- These alterations can occur independently of age, hypertension, ischemic heart disease, or left ventricular hypertrophy.
- The association with microangiopathy and reversibility remains unclear.
Purpose of the Study:
- To investigate diastolic function in young, recently diagnosed IDDM patients.
- To assess the impact of microangiopathy on diastolic function.
- To evaluate diastolic function using Doppler echocardiography.
Main Methods:
- Studied 55 subjects: 15 healthy, 30 IDDM without microangiopathy, 10 IDDM with microangiopathy.
- All subjects were under 35, with no risk factors for coronary artery disease, hypertension, or autonomic neuropathy.
- Diastolic function assessed via Doppler echocardiography of mitral flow and isovolumetric relaxation time.
Main Results:
- Diabetics with microangiopathy showed significantly altered mitral inflow velocities (wave A and E) compared to those without and healthy controls.
- Continuous parameters revealed no significant differences between healthy and diabetic subjects without microangiopathy.
- Discrete parameters indicated diastolic damage in 48% of diabetics without microangiopathy and 90% with it, versus 0% in healthy subjects.
Conclusions:
- Young, recently diagnosed IDDM patients exhibit preclinical diastolic dysfunction.
- The severity of diastolic dysfunction increases with the presence of microangiopathy.