Dawson A, Morris A D, Struthers A D
Division of Medicine and Therapeutics, University of Dundee, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK.
Diabetologia. 2005 Oct;48(10):1971-9. doi: 10.1007/s00125-005-1896-y. Epub 2005 Aug 11.
AIMS/HYPOTHESIS: Patients with type 2 diabetes mellitus are at greater cardiovascular risk than the general population. Although it is widely acknowledged that diabetes is a risk factor for coronary artery disease, the increased prevalence of potentially lethal left ventricular abnormalities in this population is less well appreciated.
We carried out an echocardiographic study of 500 subjects with type 2 diabetes mellitus to assess the prevalence of left ventricular hypertrophy (LVH) and left ventricular systolic dysfunction (LVSD). We also assessed whether abnormalities in diastolic filling parameters were present.
Of the 371 patients in whom left ventricular mass could be successfully assessed, 264 had LVH (71%). Left ventricular systolic dysfunction was much less common, being present in 16/385 patients (4.2%). Long axis contraction was abnormal in 29/429 patients (6.8%). Diastolic filling abnormalities were present in 178/435 (41%) of patients who could be classified using the selected criteria.
We conclude that left ventricular abnormalities are common in type 2 diabetic patients. As medical therapy is available for both LVH and LVSD and has been demonstrated to reduce cardiovascular death, these left ventricular abnormalities could be ideal targets for screening, followed by selective therapeutic intervention.
目的/假设：2型糖尿病患者的心血管风险高于普通人群。尽管糖尿病是冠状动脉疾病的危险因素已被广泛认可，但该人群中潜在致命的左心室异常患病率升高却较少受到重视。
我们对500例2型糖尿病患者进行了超声心动图研究，以评估左心室肥厚（LVH）和左心室收缩功能障碍（LVSD）的患病率。我们还评估了舒张期充盈参数是否存在异常。
在371例能够成功评估左心室质量的患者中，264例有LVH（71%）。左心室收缩功能障碍则少见得多，385例患者中有16例（4.2%）存在该情况。429例患者中有29例（6.8%）长轴收缩异常。在435例可根据选定标准分类的患者中，178例（41%）存在舒张期充盈异常。
我们得出结论，左心室异常在2型糖尿病患者中很常见。由于针对LVH和LVSD均有药物治疗，且已证明可降低心血管死亡风险，这些左心室异常可能是筛查的理想目标，随后进行选择性治疗干预。
