Schannwell C M, Schneppenheim M, Perings S, Plehn G, Strauer B E
Clinic of Cardiology, Pneumology and Angiology, Heinrich Heine University, Düsseldorf, Germany.
Cardiology. 2002;98(1-2):33-9. doi: 10.1159/000064682.
AIMS/HYPOTHESIS: Early determination of myocardial manifestations of diabetes mellitus is of major importance, since myocardial involvement considerably influences the prognosis of diabetic patients. The aim of this study was to investigate whether young patients with insulin-dependent diabetes mellitus and normal systolic left ventricular (LV) function already show a diastolic LV dysfunction and an increased risk of arrhythmias.
Echocardiography was performed in 87 patients suffering from type I diabetes mellitus, without known cardiac disease and in 87 controls. Patients with a known manifest cardiac disease or a long-term diabetic syndrome were excluded. Morphological parameters were determined using M-mode echocardiography. Doppler echocardiography was used to evaluate parameters of LV diastolic function. The risk of arrhythmia was assessed by means of electrocardiography, heart rate variability, and late potential analysis.
The left atrial and ventricular dimensions and systolic functional parameters of all patients were normal. A diastolic dysfunction with a reduction in early diastolic filling, an increase in atrial filling, an extension of isovolumetric relaxation and deceleration time was documented in diabetic patients, as well as an increased number of supraventricular and ventricular premature beats.
Even young patients with diabetes mellitus suffer from a diastolic dysfunction while systolic ventricular function is normal. Therefore, echocardiography with measurements of diastolic functional parameters appears to be a sensitive method for evaluating the manifestation and course of early diabetic cardiomyopathy.
目的/假设：早期确定糖尿病的心肌表现至关重要，因为心肌受累会显著影响糖尿病患者的预后。本研究的目的是调查胰岛素依赖型糖尿病且左心室（LV）收缩功能正常的年轻患者是否已经出现舒张期LV功能障碍和心律失常风险增加。
对87例无已知心脏病的I型糖尿病患者和87例对照者进行了超声心动图检查。排除已知有明显心脏病或长期糖尿病综合征的患者。使用M型超声心动图确定形态学参数。用多普勒超声心动图评估LV舒张功能参数。通过心电图、心率变异性和晚电位分析评估心律失常风险。
所有患者的左心房和心室大小及收缩功能参数均正常。糖尿病患者存在舒张功能障碍，表现为舒张早期充盈减少、心房充盈增加、等容舒张期延长和减速时间延长，以及室上性和室性早搏数量增加。
即使是糖尿病年轻患者，在心室收缩功能正常时也存在舒张功能障碍。因此，测量舒张功能参数的超声心动图似乎是评估早期糖尿病性心肌病表现和病程的一种敏感方法。
