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NIDDM as unfavorable factor to the postinfarctual ventricular function in the elderly: echocardiography study
A Azzarelli1, F L Dini, R Cristofani
1Unitá Operativa di Cardiologia, Ospedale San Francesco, Barga, Lucca, Italy.
Coronary Artery Disease
|August 1, 1995
Summary
Elderly patients with non-insulin-dependent diabetes mellitus show impaired recovery of left ventricular kinesis after acute myocardial infarction. This lack of recovery is linked to a higher incidence of heart failure and poorer outcomes.
Area of Science:
- Cardiology
- Geriatrics
- Endocrinology
Background:
- Aging and diabetes mellitus are significant risk factors for heart failure post-acute myocardial infarction (AMI).
- Left ventricular (LV) parietal kinesis changes are crucial indicators of cardiac function after AMI.
Purpose of the Study:
- To evaluate the impact of aging and non-insulin-dependent diabetes mellitus (NIDDM) on LV kinesis recovery following AMI.
- To assess the association between NIDDM, LV kinesis, and heart failure development in elderly AMI patients.
Main Methods:
- Echocardiography was used to assess LV wall motion score index in 82 elderly AMI patients over 6 months.
- Patients were divided into two groups: NIDDM (n=36) and non-diabetic (n=46).
- Multivariate analysis identified predictors of LV kinesis changes and heart failure events.
Main Results:
- Patients with NIDDM exhibited a lack of significant recovery in LV kinesis compared to non-diabetic patients.
- NIDDM was an independent predictor of impaired LV kinesis recovery (P < 0.01).
- Heart failure incidence was significantly higher in the NIDDM group during hospitalization and follow-up (P < 0.004).
Conclusions:
- NIDDM is associated with poor LV kinesis recovery after AMI in elderly patients.
- Impaired LV kinesis recovery in NIDDM patients adversely affects in-hospital and long-term outcomes, increasing heart failure prevalence.
- NIDDM is a critical factor contributing to unfavorable outcomes post-AMI.