Karamitsos Theodoros D, Karvounis Haralambos I, Didangelos Triantafyllos P, Papadopoulos Christodoulos E, Kachrimanidou Melania K, Selvanayagam Joseph B, Parharidis Georgios E
First Cardiology Department, AHEPA University Hospital, Thessaloniki, Greece.
Cardiology. 2008;109(2):99-104. doi: 10.1159/000105549. Epub 2007 Aug 14.
The aim of the study was to evaluate left ventricular diastolic function and its relation to aortic wall stiffness in patients with type 1 diabetes mellitus without coronary artery disease or hypertension.
Sixty-six patients with type 1 diabetes mellitus were examined by echocardiography and divided into two groups according to the diastolic filling pattern determined by mitral annulus tissue Doppler velocities. Group A patients (n = 21) presented diastolic dysfunction with a peak early diastolic mitral annular velocity (Em)/peak late diastolic mitral annular velocity (Am) ratio <1 whereas in group B patients (n = 45) the Em/Am ratio was >1. Coronary artery disease was excluded based on normal thallium scintigraphy. Aortic stiffness index was calculated from aortic diameters measured by echocardiography, using accepted criteria.
Aortic stiffness index differed significantly among the two groups. Significant correlations were found between parameters of left ventricular diastolic function (Em/Am, isovolumic relaxation time, deceleration time) and aortic stiffness index. Multiple stepwise linear regression analysis revealed aortic stiffness index (beta = -0.39, p = 0.001) and isovolumic relaxation time (beta = -0.46, p < 0.001) as the main predictors of Em/Am ratio.
Aortic stiffness is increased in type 1 diabetic patients with left ventricular diastolic dysfunction. This impairment in aortic elastic properties seems to be related to parameters of diastolic function.
本研究旨在评估无冠状动脉疾病或高血压的1型糖尿病患者的左心室舒张功能及其与主动脉壁僵硬度的关系。
66例1型糖尿病患者接受了超声心动图检查，并根据二尖瓣环组织多普勒速度确定的舒张期充盈模式分为两组。A组患者（n = 21）表现为舒张功能障碍，舒张早期二尖瓣环峰值速度（Em）/舒张晚期二尖瓣环峰值速度（Am）比值<1，而B组患者（n = 45）的Em/Am比值>1。基于正常的铊闪烁扫描排除冠状动脉疾病。根据公认标准，通过超声心动图测量的主动脉直径计算主动脉僵硬度指数。
两组间主动脉僵硬度指数差异显著。左心室舒张功能参数（Em/Am、等容舒张时间、减速时间）与主动脉僵硬度指数之间存在显著相关性。多元逐步线性回归分析显示，主动脉僵硬度指数（β = -0.39，p = 0.001）和等容舒张时间（β = -0.46，p < 0.001）是Em/Am比值的主要预测因素。
有左心室舒张功能障碍的1型糖尿病患者主动脉僵硬度增加。主动脉弹性特性的这种损害似乎与舒张功能参数有关。
