Department of Cardiology, Malmö University Hospital, Lund University, Lund, Sweden.
Cardiovasc Diabetol. 2010 Jan 18;9:2. doi: 10.1186/1475-2840-9-2.
The aims of this study were to estimate the prevalence of left ventricular systolic (LVSD) and diastolic (LVDD) dysfunction, and to test if BNP and urinary albumin excretion rate (AER) are related to LVSD, LVD and left ventricular mass (LVM) in asymptomatic type 2 diabetes patients.
Presence of LVSD, LVDD and LVM, determined with echocardiography, was related to levels of BNP and AER in 153 consecutive asymptomatic patients with type 2 diabetes.
LVSD was present in 6.1% of patients whereas 49% (29% mild, 19% moderate and 0.7% severe) had LVDD and 9.4% had left ventricular hypertrophy. Increasing age (P < 0.0001) was the only independent variable related to mild LVDD whereas increasing BNP (P = 0.01), systolic blood pressure (P = 0.01), age (P = 0.003) and female gender (P = 0.04) were independent determinants of moderate to severe LVDD. AER (P = 0.003), age (P = 0.01) and male gender (P = 0.006) were directly and independently related to LVM.
About half of asymptomatic type 2 diabetes patients have LVDD. Of those, more than one third display moderate LVDD pattern paralleled by increases in BNP, suggesting markedly increased risk of heart failure, especially in females, whereas AER and male sex are related to LVM.
本研究旨在评估无症状 2 型糖尿病患者左心室收缩(LVSD)和舒张(LVDD)功能障碍的发生率,并检验 BNP 和尿白蛋白排泄率(AER)与 LVSD、LVD 和左心室质量(LVM)的相关性。
对 153 例连续的无症状 2 型糖尿病患者进行超声心动图检查,确定 LVSD、LVDD 和 LVM 的存在情况,并检测其 BNP 和 AER 水平。
6.1%的患者存在 LVSD,49%(29%轻度、19%中度和 0.7%重度)的患者存在 LVDD,9.4%的患者存在左心室肥厚。年龄增加(P<0.0001)是轻度 LVDD 的唯一独立相关变量,而 BNP 升高(P=0.01)、收缩压升高(P=0.01)、年龄增加(P=0.003)和女性(P=0.04)是中度至重度 LVDD 的独立决定因素。AER(P=0.003)、年龄(P=0.01)和男性(P=0.006)与 LVM 直接相关且独立。
约一半的无症状 2 型糖尿病患者存在 LVDD。其中,超过三分之一的患者存在中度 LVDD 模式,同时 BNP 升高,提示心力衰竭风险显著增加,尤其是女性,而 AER 和男性与 LVM 相关。