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Left ventricular performance in diabetic patients without clinical heart disease. Evaluation by systolic time
Insights
Diabetic patients show significant cardiac dysfunction, even without clinical symptoms. Key indicators like pre-ejection period and ejection fraction are notably altered, suggesting early heart changes in diabetes.
Area of Science:
- Cardiology
- Diabetology
- Non-invasive cardiovascular diagnostics
Background:
- Diabetes mellitus is a growing global health concern.
- Subclinical cardiac dysfunction is increasingly recognized in diabetic populations.
- Early detection of cardiac involvement is crucial for timely intervention.
Purpose of the Study:
- To assess left ventricular performance in diabetic patients without overt cardiac disease.
- To identify early echocardiographic and systolic time interval changes indicative of cardiac involvement.
Main Methods:
- Systolic time intervals (STI) including pre-ejection period (PEP) and left ventricular ejection time (LVET) were measured.
- Echocardiography was performed to evaluate parameters like ejection fraction (EF) and minor axis diameter changes.
- Diabetic patients were compared to a healthy control group.
Main Results:
- Diabetic patients exhibited significant alterations in all measured systolic time intervals (P < 0.001).
- The PEP/LVET ratio increased by 25%, and PEP increased by 12% in diabetics.
- Echocardiography revealed a 20% decrease in ejection fraction and abnormal minor axis diameter changes in some diabetic patients.
Conclusions:
- Diabetic patients without clinical cardiac symptoms display significant subclinical left ventricular dysfunction.
- Non-invasive measures like STI and echocardiography can detect early cardiac changes in diabetes.
- These findings highlight the need for cardiac monitoring in diabetic patients.
Abstract:
To examine left ventricular performance in diabetic patients without clinical evidence of cardiac involvement, systolic time intervals (pre-ejection period, left ventricular ejection time index and ratio of pre-ejection period to left ventricular ejection time) and echocardiographic measures (percentage changes in minor axis diameter, end-diastolic and end-systolic diameter, end- diastolic volume and end-systolic volumes, stroke volume and ejection fraction), were obtained. There were 89 diabetic patients and 93 control subjects evaluated for systolic time intervals, and 40 diabetic patients and 20 control subjects evaluated by echocardiogram. The diabetic group demonstrated significant (P less than 0.001) differences from the normal control group in each of the noninvasive measures of systolic time intervals. Pre-ejection period/left ventricular ejection time ration was increased by 25 percent and the pre-ejection period was increased by 12 percent in the diabetic patients. Among 40 diabetic patients studied by echocardiography, abnormal percentage change in minor axis diameter, (less than 30 percent) occurred in six individuals. Ejection fraction was decreased by 20 percent as compared to the control group, whereas end-diastolic pressure was not significantly different in the groups.
