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Residual left ventricular pump function following acute myocardial infarction in postmenopausal diabetic women
1Second Department of Internal Medicine, Kansai Medical University, Osaka, Japan.
Insights
Diabetic postmenopausal women experience significant left ventricular dysfunction after myocardial infarction, with greater changes than diabetic men. This highlights the impact of diabetes and female sex on cardiac remodeling post-heart attack.
Area of Science:
- Cardiology
- Diabetology
- Cardiovascular Research
Background:
- Diabetes mellitus significantly increases cardiac failure risk post-myocardial infarction (MI) in women.
- Limited data exists on left ventricular (LV) pump function in diabetic women after MI.
Purpose of the Study:
- To compare the impact of diabetes mellitus on LV pump function in postmenopausal women versus age-matched men during the first year after MI.
- To investigate sex-specific differences in cardiac remodeling in diabetic patients post-MI.
Main Methods:
- Radionuclide angiography was used to assess LV pump function.
- Patients with and without diabetes mellitus were studied at 3 weeks and 1 year post-MI.
- The study included 50 diabetic patients (21 women, 29 men) and 62 non-diabetic patients (25 women, 37 men).
Main Results:
- Diabetic patients showed increased LV end-diastolic volume and decreased LV ejection fraction, regional ejection fraction, and pressure:volume ratio.
- Non-diabetic patients had stable LV indices during the first year post-MI.
- Diabetic women exhibited greater adverse changes in LV remodeling compared to diabetic men.
Conclusions:
- Diabetes mellitus and female sex are critical factors in adverse LV remodeling post-MI.
- Postmenopausal women with diabetes mellitus experience significant LV dysfunction and remodeling after myocardial infarction.
Background:
The Framingham Study indicated that women with diabetes mellitus developed cardiac failure four times more often than those without diabetes mellitus after acute myocardial infarction. However, there is little information on residual left ventricular pump function after myocardial infarction in female diabetic patients.
Methods:
To evaluate the difference between postmenopausal women and age-matched men in the impact of diabetes mellitus on left ventricular pump function during the first year after myocardial infarction, radionuclide angiography was performed during the third week after acute myocardial infarction and again 1 year later in 50 patients (21 women, 29 men) with diabetes mellitus and 62 patients (25 women, 37 men) without diabetes mellitus.
Results:
Although the radionuclide angiographic indices did not change during the first year after myocardial infarction in non-diabetic patients, left ventricular end-diastolic volume increased, and the left ventricular ejection fraction, the regional ejection fraction of the non-infarcted area, and the ratio of arterial systolic blood pressure to left ventricular end-systolic volume (pressure:volume ratio) decreased in the diabetic patients. Furthermore, the degree of change in the left ventricular end-diastolic volume, the left ventricular ejection fraction, the regional ejection fraction of the non-infarcted area, and the pressure:volume ratio in diabetic women was larger than that in diabetic men.
Conclusion:
The increase in the left ventricular end-diastolic volume and the decrease in the regional ejection fraction of the non-infarcted area during the first year after myocardial infarction in postmenopausal women with diabetes mellitus indicate that female sex associated with diabetes mellitus may be important factors in left ventricular remodeling in postmenopausal women.