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[糖尿病患者左心室舒张早期功能障碍及其与组织病理学发现的关系]

[Early diastolic dysfunction of the left ventricle and its relation to histopathological findings in patients with diabetes mellitus].

作者信息

Minamoto M, Shimizu M, Suematsu T, Sugihara N, Kita Y, Shimada T, Murakami T, Ohsato K, Konishi K, Takeda R

机构信息

Second Department of Internal Medicine, School of Medicine, Kanazawa University.

出版信息

J Cardiol. 1990;20(2):293-300.

PMID:2104405
Abstract

The relation of left ventricular diastolic function and the histopathological findings of the myocardium in patients with diabetes mellitus were observed using echocardiography and endomyocardial biopsy. The subjects consisted of six diabetic patients (mean age 49.3 years) and eight normal control subjects (mean age 44.8 years). Coronary angiography had no significant stenotic lesions in their coronary arteries. Their diabetic complications were mild to moderate in severity. Echoes from the left ventricular margin of the septum and from the posterior left ventricular wall were traced on a digitizing board; then the isovolumic relaxation period, rapid filling period, slow filling period and atrial contraction period were determined to calculate fractional shortening (FS), isovolumic relaxation time (IRT), and three filling volumes (RFV, SFV and ACV). The quotients of the left ventricular filling volume and stroke volume were also determined. Right ventricular endomyocardial biopsies were performed to determine the diameters of myocytes, the percentage of fibrosis and the eccentricity e, as a parameter of the degree of myocardial dysarrangement. The results were as follows: IRT was significantly longer and RFV/SV was significantly greater in patients with diabetes mellitus than those among the controls. Also the diameters of myocytes and the percentage of fibrosis were significantly greater, while the eccentricity e was less compared to that of the controls. There were no significant correlations, among IRT, RFV/SV, the diameters of myocytes, and eccentricity e, but the percentage of fibrosis significantly correlated with IRT and RFV/SV (r = 0.62, r = -0.63). IRT and RFV/SV were mainly responsible for the percentage of fibrosis.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

采用超声心动图和心内膜心肌活检观察糖尿病患者左心室舒张功能与心肌组织病理学结果的关系。研究对象包括6例糖尿病患者(平均年龄49.3岁)和8例正常对照者(平均年龄44.8岁)。冠状动脉造影显示其冠状动脉无明显狭窄病变。他们的糖尿病并发症严重程度为轻度至中度。在数字化板上描绘室间隔左心室边缘和左心室后壁的回声;然后确定等容舒张期、快速充盈期、缓慢充盈期和心房收缩期,以计算缩短分数(FS)、等容舒张时间(IRT)和三个充盈容积(RFV、SFV和ACV)。还测定了左心室充盈容积与每搏量的商数。进行右心室心内膜心肌活检以确定心肌细胞直径、纤维化百分比和偏心度e,作为心肌排列紊乱程度的参数。结果如下:糖尿病患者的IRT显著延长,RFV/SV显著高于对照组。此外,与对照组相比,心肌细胞直径和纤维化百分比显著更大,而偏心度e更小。IRT、RFV/SV、心肌细胞直径和偏心度e之间无显著相关性,但纤维化百分比与IRT和RFV/SV显著相关(r = 0.62,r = -0.63)。IRT和RFV/SV是纤维化百分比的主要影响因素。(摘要截短至250字)

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