Boyer John K, Thanigaraj Srihari, Schechtman Kenneth B, Pérez Julio E
Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
Am J Cardiol. 2004 Apr 1;93(7):870-5. doi: 10.1016/j.amjcard.2003.12.026.
To determine the prevalence of left ventricular diastolic dysfunction in asymptomatic, normotensive patients with type 2 diabetes mellitus, we studied 61 consecutive normotensive patients with type 2 diabetes using conventional Doppler echocardiography at rest (deceleration time, isovolumic relaxation time, early diastolic velocity [E]/peak atrial systolic velocity [A] ratio), and during the Valsalva maneuver. In addition, mitral annular velocity and velocity of flow propagation were assessed in all patients using tissue Doppler imaging (TDI) and color M-mode echocardiography. A standard resting echocardiogram excluded significant valvular disease and stress echocardiography excluded significant coronary artery disease in those with diastolic dysfunction. Diastolic dysfunction was found in 43 of 57 patients (75%) when all of the above echocardiographic techniques were used. TDI detected diastolic dysfunction more often (63%) than any other echocardiographic approach. Thus, the prevalence of left ventricular diastolic dysfunction in asymptomatic, normotensive patients with type 2 diabetes without significant coronary artery disease is much higher than previously suspected. TDI markedly improved the echocardiographic detection of diastolic dysfunction in asymptomatic patients with type 2 diabetes.
为了确定无症状、血压正常的2型糖尿病患者左心室舒张功能障碍的患病率，我们使用常规多普勒超声心动图对61例连续的血压正常的2型糖尿病患者进行了研究，检测静息状态下（减速时间、等容舒张时间、舒张早期速度[E]/心房收缩期峰值速度[A]比值）以及瓦尔萨尔瓦动作期间的情况。此外，使用组织多普勒成像（TDI）和彩色M型超声心动图对所有患者评估二尖瓣环速度和血流传播速度。标准静息超声心动图排除了严重瓣膜疾病，而对于舒张功能障碍患者，负荷超声心动图排除了严重冠状动脉疾病。当使用上述所有超声心动图技术时，57例患者中有43例（75%）发现舒张功能障碍。TDI检测到舒张功能障碍的频率（63%）高于任何其他超声心动图方法。因此，无严重冠状动脉疾病的无症状、血压正常的2型糖尿病患者左心室舒张功能障碍的患病率远高于先前的推测。TDI显著提高了无症状2型糖尿病患者舒张功能障碍的超声心动图检测率。
