Diabetes mellitus is associated with high mortality from cardiac disease attributed to coronary artery atherosclerosis or systemic hypertension. Several investigators have shown that abnormalities of left ventricular (LV) diastolic function are
common
even in diabetics without clinical manifestations of congestive heart failure, and that these abnormalities results from microangiopathic process in the heart and from metabolic abnormalities inherent to diabetes mellitus.
To determine the diagnostic parameters of the LV diastolic filling defect in a variety of adult-onset diabetes mellitus, we evaluated the LV·inflow velocity pattern in 30 diabetics using pulsed Doppler echocardiography compared with normal 15
subjects.
The diabetics were divided into 3 groups according to the number of microangiopathic complications i.e., nephropathy, retinopathy and peripheral neuropathy. (Group I:10 cases without complication, Group II:10 cases with 1 or 2 complications,
Group
III:10 cases with 3 complications)
The LV inflow velocity patterns were recorded from the apical approach. Peak velocity of the rapid filling phase (PFVE), that in the atrial systole 9PFVA), E/A ratio, acceleration time (AT), deceleration time (DT), acceleration rate (ATR) and
deceleration rate (DTR) were measured in the LV inflow patterns.
@ES The results were as follows:
@EN 1) AT and ATR were no statistical significance of differences among groups.
2) PFVA in control (0.58±0.12m/sec and group I(0.62±0.17m/sec) were significantly decreased (P<0.005, P<0.05) compared to group III (0.75±0.15m/sec). It showed a gradually increased tendency in groups with more microangiopathic
complications.
Whereas PFVE was significantly reduced in group III compared to the control subjects (0.63±0.18 VS (0.72±0.04m/sec. P<0.05).
3) E/A ratio in control (1.30±0.24) and group I(1.06±0.23) were significantly increased (P<0.001, P<0.005) compared to group III (0.82±0.33).
4) DT showed a statistical significance of difference in group II(192.67±23.4msec) and group III (200.29±29.22msec) compared to the control (152.04±23.19msec, P<0.005, P<0.0001) and group I(160.00±32.42msec, P<0.005). It was prolonged in
groups
with more microangiopathic complications.
5) DTR was also decreased in group II(270.14±110cm/sec², p<0.05) and group III(260.18±95cm/sec², P<0.05) compared to the control (320.14±124cm/sec²) and group I(322.20±89cm/sec²).
In conclusion, data indicated that indices of LV inflow patterns 9PFVE, PFVA, E/A ratio, DT, DTR) were suggested to be useful in identifying abnormal LV diastolic filling properties in adult-onset diabetes mellitus, and a correlation existed
between
diabetic microangiopathic complications and diastolic filling pattern.
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