Abstract
In this study left ventricular diastolic function at rest was evaluated in ten newly diagnosed, non-insulin-dependent diabetic patients by Doppler echocardiography, performed at the onset of disease and after 6 and 12 months of adequate glycaemic control. Glycosylated haemoglobin A1C, total cholesterol and triglyceride levels were assessed at the same time. The control group consisted of ten healthy subjects of matching age and body mass index. The following parameters of left ventricular function were evaluated: ejection fraction (EF), peak velocity of the early (E) and late atrial (A) mitral flow, A/E ratio, duration of the early (Ei) and of the atrial (Ai) filling phase, and heart rate. The diabetic patients had significantly higher total cholesterol and triglyceride levels compared with healthy subjects. These remained elevated throughout the follow-up period, in spite of improved glycaemic control. A significantly shorter duration of Ei (0.15±0.008 vs 0.18±0.004,P<0.01) and a higher value of A (0.51±0.02 vs 0.39±0.01,P<0.001) and A/E (1.06±0.05 vs 0.73±0.02,P<0.001) were found in the diabetic patients before treatment. The parameters did not significantly change after 1 year of adequate glycaemic control. These results indicate a left ventricular filling abnormality which is present in newly diagnosed non-insulin-dependent diabetic patients and does not reverse with improved glycaemic control.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Zoneraich S, Silverman G, Zoneraich O, Primary myocardial disease, diabetes mellitus and small vessel disease. Am Heart J 5:754–755, 1980
Brownlee M, Cerami A, Vlassara H, Advanced glycosylation end products in tissue and biochemical basis of diabetic complications. N Engl J Med 318:1315–1322, 1988
Heyliger CE, Prakash A, McNeill JH, Alterations in cardiac sarcolemmal Ca2+ pump activity during diabetes mellitus. Am J Physiol 252:H540-H544, 1987
Watkins PJ, Mackay JD, Cardiac denervation in diabetic neuropathy. Ann Intern Med 92:304–307, 1980
Zarich SW, Nesto RW, Diabetic cardiomyopathy. Am Heart J 118:1000–1012, 1989
Zarich SW, Arbuckle BE, Cohen LR, Roberts M, Nesto RW, Diastolic abnormalities in young asymptomatic diabetic patients assessed by pulsed Doppler echocardiography. J Am Coll Cardiol 12:114–120, 1988
Carlstrom S, Karlefors T, Haemodynamic studies on newly diagnosed diabetics before and after adequate insulin treatment. Br Heart J 32:355–358, 1970
Fein SM, Kornstein LB, Strobeck JE, Altered myocardial mechanics in diabetic rats. Circ Res 47:922–923, 1980
Dillman WH, Diabetes mellitus induces changes in cardiac myosin in the rat. Diabetes 29:579–582, 1980
Fein ES, Malhotra A, Miller-Green B, Scheuer J, Sonnenblick EH, Diabetic cardiomyopathy in rats: mechanical and biochemical responses to different insulin doses. Am J Physiol 247: H817–H823, 1984
Carlstrom S, Karlefors T, Haemodynamic studies during exercise in newly diagnosed juvenile diabetics. Acta Med Scand 181:759–762, 1967
Takenaka K, Sakamoto T, Amano K, Oku J, Fujinami K, Murakami T, Toda I, Kawakubo K, Sugimoto T, Left ventricular filling determined by Doppler echocardiography in diabetes mellitus, Am J Cardiol 61:1140–1143, 1989
Riggs TW, Transue D, Doppler echocardiographic evaluation of left ventricular diastolic function in adolescents with diabetes mellitus. Am J Cardiol 65:899–902, 1990
Regan TJ, Weisse AB, Diabetic cardiomyopathy (editorial). J Am Coll Cardiol 16:1165–1166, 1992
Shapiro LM, Echocardiographic features of impaired ventricular function in diabetes mellitus. Br Heart J 47:439–444, 1982
Ganguly PK, Dhalla KS, Innes IR, Beamish RE, Dhalla NS, Altered norepinephrine turnover and metabolism in diabetic cardiomyopathy. Circ Res 25:684–693, 1986
Uusitupa M, Siitonen O, Effect of correction of hyperglycaemia on left ventricular function in non-insulin-dependent (type 2) diabetes. Acta Med Scand 231:363–368, 1983
Goldweit RS, Borer JS, Jovanovic LG, Drexler AJ, Hochreiter CA, Devereux RB, Peterson SM, Relation of haemoglobin A1 and blood glucose to cardiac function in diabetes mellitus. Am J Cardiol 56:642–646, 1985
Zarich SW, Kowalchuk GJ, McGuirre MP, Benotti PN, Mascoli EA, Left ventricular filling abnormalities in asymptomatic morbid obesity. Am J Cardiol 68:377–381, 1991
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Beljic, T., Miric, M. Improved metabolic control does not reverse left ventricular filling abnormalities in newly diagnosed non-insulin-dependent diabetes patients. Acta Diabetol 31, 147–150 (1994). https://doi.org/10.1007/BF00570369
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00570369