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在无明显心脏病的2型糖尿病患者中,代谢参数与左心室功能之间是否存在关联?

Is there any relationship between metabolic parameters and left ventricular functions in type 2 diabetic patients without evident heart disease?

作者信息

Yazici Mehmet, Ozdemir Kurtulus, Gonen Mustafa Sait, Kayrak Mehmet, Ulgen Mehmet Siddik, Duzenli Mehmet Akif, Yazici Raziye, Soylu Ahmet, Gok Hasan

机构信息

Department of Cardiology, Selcuk University, Medical Faculty, Konya, Turkey.

出版信息

Echocardiography. 2008 Aug;25(7):675-82. doi: 10.1111/j.1540-8175.2008.00690.x. Epub 2008 Apr 27.

Abstract

BACKGROUND

The aim of the present study was to evaluate left ventricle (LV) systolic and diastolic function, using tissue Doppler echocardiography (TDE) and color M-mode flow propagation velocity, in relation to blood glucose status in normotensive patients with type 2 diabetes mellitus (T2DM) who had no clinical evidence of heart disease.

METHODS

Seventy-two patients with T2DM (mean age 49.1 +/- 9.8 years) without symptoms, signs or history of heart disease and hypertension, and 50 ages matched healthy controls (mean age 46.1 +/- 9.8 years) had echocardiography. Systolic and diastolic LV functions were detected by using conventional echocardiography, TDE and mitral color M-mode flow propagation velocity (V(E)). Fasting blood glucose level (FBG) after 8 hours since eating a meal, postprandial blood glucose level (PPG), and HbA(1C) level were determined. The association of FBG, PPG and HbA(1C) with the echocardiographic parameters was investigated.

RESULTS

It was detected that although systolic functions of two groups were similar, diastolic functions were significantly impaired in diabetics. No relation of FBG and PPG with systolic and diastolic functions was determined. However, HbA(1C) was found to be related to diastolic parameters such as E/A, Em/Am, V(E) and E/V(E) (beta=-0.314, P = < 0.05; beta=-0.230, P < 0.05; beta=-0.602, P < 0.001, beta= 0.387, P < 0.005, respectively). In addition to HbA(1C), LV, diastolic functions were also correlated with age and diabetes duration.

CONCLUSION

Diastolic LV dysfunction may develop even in absence of ischemia, hypertension, and LVH in T2DM. FBG and PPG have no effect on LV functions, but HbA(1C) levels may affect diastolic parameters.

摘要

背景

本研究旨在运用组织多普勒超声心动图(TDE)和彩色M型血流传播速度,评估无心脏病临床证据的2型糖尿病(T2DM)正常血压患者的左心室(LV)收缩和舒张功能与血糖状态的关系。

方法

72例无心脏病症状、体征或病史且无高血压的T2DM患者(平均年龄49.1±9.8岁)以及50例年龄匹配的健康对照者(平均年龄46.1±9.8岁)接受了超声心动图检查。采用传统超声心动图、TDE和二尖瓣彩色M型血流传播速度(V(E))检测左心室收缩和舒张功能。测定进食后8小时的空腹血糖水平(FBG)、餐后血糖水平(PPG)和糖化血红蛋白A1C(HbA1C)水平。研究FBG、PPG和HbA1C与超声心动图参数的相关性。

结果

检测发现,尽管两组的收缩功能相似,但糖尿病患者的舒张功能明显受损。未确定FBG和PPG与收缩和舒张功能之间的关系。然而,发现HbA1C与舒张参数如E/A、Em/Am、V(E)和E/V(E)相关(β分别为-0.314,P<0.05;β为-0.230,P<0.05;β为-0.602,P<0.001;β为0.387,P<0.005)。除HbA1C外,左心室舒张功能还与年龄和糖尿病病程相关。

结论

即使在无缺血、高血压和左心室肥厚的T2DM患者中,也可能发生左心室舒张功能障碍。FBG和PPG对左心室功能无影响,但HbA1C水平可能影响舒张参数。

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