Jermendy G, Khoór S, Koltai M Z, Pogátsa G
István City Hospital, Merényi Medical Department, Budapest, Hungary.
Cardiology. 1990;77(1):9-16. doi: 10.1159/000174574.
The left ventricular diastolic and systolic functions were assessed in 27 strictly selected type 1 diabetic patients without overt heart disease and 50 age- and sex-matched control subjects. For evaluating left ventricular performance, complex mechanocardiography including digitized apexcardiography was used at rest and after symptom-limited, graded dynamic exercise. The values of diastolic/systolic time intervals and amplitude parameters did not differ significantly between the diabetic and control groups at rest. A longer value of corrected early apexcardiographic relaxation time (diabetics: 38.7 +/- 2.6 ms, controls: 17.3 +/- 2.1 ms, p less than 0.001) and a smaller normalized amplitude of relaxation (diabetics: 0.014 +/- 0.004 ms-1, controls: 0.056 +/- 0.006 ms-1, p less than 0.001) were observed after dynamic exercise suggesting disturbances of the early diastole in diabetic patients. No correlations could be found between the diastolic abnormalities and the diabetic control. Significant correlation was observed between the diastolic disorders and the duration of diabetes mellitus. Testing left ventricular performance by complex mechanocardiography including digitized apexcardiography after dynamic exercise in patients with type 1 diabetes might be useful for recognizing diastolic abnormalities even when no alterations could be identified at rest. Diastolic disorders could appear in diabetic patients without overt heart disease and clinical symptoms. Left ventricular systolic function might be normal, although exercise-induced alterations of diastolic function might already be present in type 1 diabetic patients.
对27例严格筛选出的无明显心脏病的1型糖尿病患者及50例年龄和性别匹配的对照者进行了左心室舒张和收缩功能评估。为评估左心室功能，在静息状态及症状限制的分级动态运动后，采用包括数字化心尖搏动图的复杂机械心动图检查。静息时，糖尿病组和对照组的舒张/收缩时间间期及幅度参数值无显著差异。动态运动后，观察到糖尿病患者校正后的早期心尖搏动图舒张时间较长（糖尿病组：38.7±2.6毫秒，对照组：17.3±2.1毫秒，p<0.001），舒张归一化幅度较小（糖尿病组：0.014±0.004毫秒-1，对照组：0.056±0.006毫秒-1，p<0.001），提示糖尿病患者早期舒张功能紊乱。未发现舒张异常与糖尿病控制情况之间存在相关性。观察到舒张功能障碍与糖尿病病程之间存在显著相关性。对于1型糖尿病患者，动态运动后通过包括数字化心尖搏动图的复杂机械心动图检查来测试左心室功能，即使在静息时未发现改变，也可能有助于识别舒张异常。舒张功能障碍可能出现在无明显心脏病和临床症状的糖尿病患者中。1型糖尿病患者尽管运动诱发的舒张功能改变可能已经存在，但左心室收缩功能可能正常。
