Riggs T W, Transue D
Department of Pediatrics, William Beaumont Hospital, Royal Oak, Michigan 48072.
Am J Cardiol. 1990 Apr 1;65(13):899-902. doi: 10.1016/0002-9149(90)91433-7.
Doppler echocardiograms of the mitral valve were recorded along with electrocardiograms and respirations from 20 diabetics and 16 normal subjects, all aged 10 to 15 years. E and A areas (the components of the total velocity-time integral in the early passive period of ventricular filling [E] and the late active period of atrial emptying [A], respectively), the peak E and A velocities (cm/s) and the 1/3 area fraction (or the proportion of filling in the first 1/3 of diastole) were measured. Each of the following was significantly greater for the normal subjects versus diabetic patients: peak E (96 +/- 14 vs 81 +/- 14 cm/s, p less than 0.005), E/total area (0.74 +/- 0.04 vs 0.69 +/- 0.06, p less than 0.005) and peak E/A velocity ratio (2.38 +/- 0.55 vs 1.92 +/- 0.55, p less than 0.05). The mean heart rates and ages were not significantly different for the 2 groups. The remaining parameters (peak A velocity, A/total area, E/A area, and 1/3 area fraction) were also not significantly different for the 2 groups. This study is the first to demonstrate diastolic dysfunction in pediatric patients with diabetes and may indicate abnormalities of ventricular relaxation or compliance in diabetes mellitus.
对20名年龄在10至15岁的糖尿病患者和16名正常受试者进行了二尖瓣多普勒超声心动图检查，并同步记录了心电图和呼吸情况。测量了E和A面积（分别为心室舒张早期被动充盈期[E]和心房排空晚期主动充盈期[A]的总速度-时间积分的组成部分）、E和A峰值速度（厘米/秒）以及1/3面积分数（即舒张期前1/3的充盈比例）。与糖尿病患者相比，正常受试者的以下各项指标均显著更高：E峰值（96±14对81±14厘米/秒，p<0.005）、E/总面积（0.74±0.04对0.69±0.06，p<0.005）以及E/A峰值速度比值（2.38±0.55对1.92±0.55，p<0.05）。两组的平均心率和年龄无显著差异。其余参数（A峰值速度、A/总面积、E/A面积和1/3面积分数）在两组间也无显著差异。本研究首次证实了糖尿病患儿存在舒张功能障碍，可能提示糖尿病患者心室舒张或顺应性异常。
