Suppr
超能文献

无自主神经病变及合并自主神经病变的血压正常的2型糖尿病患者的左心室收缩和舒张功能：放射性核素心室造影研究

Left ventricular systolic and diastolic function in normotensive type 2 diabetic patients with or without autonomic neuropathy: a radionuclide ventriculography study.

作者信息

Didangelos Triantafyllos P, Arsos Georgios, Karamitsos Theodoros, Iliadis Fotios, Papageorgiou Athanasios, Moralidis Efstratios, Athyros Vasilios

机构信息

First Propeudetic Department of Internal Medicine, Diabetes Center, Medical School, Aristotle University of Thessaloniki, "AHEPA'' Hospital, Thessaloniki, Greece

Laboratory of Nuclear Medicine, Medical School, Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki, Greece.

出版信息

Angiology. 2014 Nov;65(10):877-82. doi: 10.1177/0003319713510966. Epub 2013 Nov 21.

DOI:10.1177/0003319713510966

PMID:24265250

Abstract

We investigated the relation between diabetic autonomic neuropathy (DAN) and left ventricular (LV) function in 59 patients with type 2 diabetes mellitus (T2DM) free of coronary artery disease (CAD) or hypertension. Diabetic autonomic neuropathy was established by ≥2 abnormal autonomic nervous function tests. Left ventricular systolic and diastolic functions were assessed by resting radionuclide ventriculography. Compared with non-DAN patients (n=24), patients with DAN (n=35) had an increased adjusted atrial contribution to ventricular filling (A/V%, 30.1%±8.2% vs 26.5%±5.1%; P=.031), suggestive of diastolic dysfunction (DD). There were no differences between the 2 groups in peak filling rate, first 1/3 filling fraction, ejection fraction, cardiac output, and cardiac index. Patients with diabetic autonomic neuropathy had an increased heart rate (77.8±6.3 vs 69.3±3.3 bpm; P<.0001) and a higher rest LV workload (10,072±1165 vs 8606±1075 bpm mm Hg; P<.0001). Patients with DAN T2DM without CAD or hypertension have DD, increased A/V index, and a higher LV working load than non-DAN patients.

摘要

我们在59例无冠状动脉疾病（CAD）或高血压的2型糖尿病（T2DM）患者中研究了糖尿病自主神经病变（DAN）与左心室（LV）功能之间的关系。通过≥2项异常自主神经功能测试确诊糖尿病自主神经病变。通过静息放射性核素心室造影评估左心室收缩和舒张功能。与非DAN患者（n = 24）相比，DAN患者（n = 35）的心房对心室充盈的校正贡献增加（A/V%，30.1%±8.2%对26.5%±5.1%；P = .031），提示舒张功能障碍（DD）。两组在峰值充盈率、前1/3充盈分数、射血分数、心输出量和心脏指数方面无差异。糖尿病自主神经病变患者的心率增加（77.8±6.3对69.3±3.3次/分钟；P < .0001），静息左心室工作量更高（10,072±1165对8606±1075次/分钟·毫米汞柱；P < .0001）。无CAD或高血压的DAN T2DM患者比非DAN患者有舒张功能障碍、A/V指数增加和更高的左心室工作负荷。