Patel T M, Mathur V S, Dave S H, Kothari S S, Patel T K
Institute of Cardiology A-1 Civil Hospital, Ahmedabad, India.
Panminerva Med. 1991 Jan-Mar;33(1):6-10.
Fifty otherwise healthy patients with diabetes mellitus (37 males, 13 females; mean age: 53 +/- 10 years) of more than five year duration were compared with twenty six healthy age and sex matched controls. Detailed echocardiographic evaluation was done in all and systolic time intervals (STI) were measured. In diabetics, metabolic control and presence of microangiopathy were evaluated. PEP Index (patients: 146.23 +/- 17.04; controls: 121.99 +/- 5.15; p less than 0.001), PEP/LVET ratio (patients: 0.38 +/- 0.07; controls: 0.32 +/- 0.02; p less than 0.001), LVEF% (patients: 54.1 +/- 10.56; controls: 64.71 +/- 6.33; p less than 0.001), all were significantly altered in diabetics suggesting left ventricular dysfunction. The left ventricular posterior wall thickness (patients: 0.96 +/- 0.23 cm; controls: 0.85 +/- 0.12 cm; p less than 0.01) and interventricular septal thickness (patients: 1.2 +/- 0.24 cm; controls: 0.87 +/- 0.25 cm; p less than 0.001) in diastole were increased in diabetics. The PEPI correlated with day-to-day control but not with chronic glycemic control of diabetes mellitus. The PEP/LVET was significantly increased in patients with severe, as compared to those with none or mild microangiopathy (p less than 0.05). Thus, significant left ventricular dysfunction is evident in asymptomatic, otherwise healthy diabetics. Both metabolic control and microangiopathy may be responsible for the abnormalities.
选取50例病程超过5年、无其他健康问题的糖尿病患者（男37例，女13例；平均年龄：53±10岁），与26例年龄和性别匹配的健康对照者进行比较。对所有研究对象均进行了详细的超声心动图评估，并测量了收缩期时间间期（STI）。评估糖尿病患者的代谢控制情况及微血管病变情况。射血前期指数（患者：146.23±17.04；对照者：121.99±5.15；p＜0.001）、射血前期与左室射血时间比值（患者：0.38±0.07；对照者：0.32±0.02；p＜0.001）、左室射血分数（患者：54.1±10.56；对照者：64.71±6.33；p＜0.001），糖尿病患者的这些指标均有显著改变，提示左心室功能障碍。糖尿病患者舒张期左室后壁厚度（患者：0.96±0.23cm；对照者：0.85±0.12cm；p＜0.01）和室间隔厚度（患者：1.2±0.24cm；对照者：0.87±0.25cm；p＜0.001）增加。射血前期指数与糖尿病患者的日常血糖控制相关，但与慢性血糖控制无关。与无微血管病变或轻度微血管病变的患者相比，重度微血管病变患者的射血前期与左室射血时间比值显著升高（p＜0.05）。因此，在无症状的、无其他健康问题的糖尿病患者中，明显存在显著的左心室功能障碍。代谢控制和微血管病变可能均与这些异常情况有关。
