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患有糖尿病的猫在没有结构性心脏病的情况下存在舒张功能障碍。

Cats with diabetes mellitus have diastolic dysfunction in the absence of structural heart disease.

作者信息

Pereira N J, Novo Matos J, Baron Toaldo M, Bartoszuk U, Summerfield N, Riederer A, Reusch C, Glaus T M

机构信息

Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057 Zurich, Switzerland.

Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057 Zurich, Switzerland.

出版信息

Vet J. 2017 Jul;225:50-55. doi: 10.1016/j.tvjl.2017.04.017. Epub 2017 May 3.

Abstract

Diabetes mellitus (DM) can result in cardiovascular dysfunction and heart failure characterized by diastolic dysfunction with or without the presence of systolic dysfunction in people and laboratory animals. The objective of this prospective study was to determine if cats with newly diagnosed DM had myocardial dysfunction and, if present, whether it would progress if appropriate antidiabetic therapy was commenced. Thirty-two diabetic cats were enrolled and received baseline echocardiographic examination; of these, 15 cats were re-examined after 6 months. Ten healthy age- and weight-matched cats served as controls. Diabetic cats at diagnosis showed decreased diastolic, but not systolic function, when compared to healthy controls, with lower mitral inflow E wave (E) and E/E' than controls. After 6 months, E and E/IVRT' decreased further in diabetic cats compared to the baseline evaluation. After excluding cats whose DM was in remission at 6 months, insulin-dependent diabetic cats had lower E, E/A and E' than controls. When classifying diastolic function according to E/A and E'/A', there was shift towards impaired relaxation patterns at 6 months. All insulin-dependent diabetic cats at 6 months had abnormal diastolic function. These results indicate that DM has similar effects on diastolic function in feline and human diabetics. The dysfunction seemed to progress rather than to normalize after 6 months, despite antidiabetic therapy. In cats with pre-existing heart disease, the development of DM could represent an important additional health risk.

摘要

糖尿病(DM)可导致心血管功能障碍和心力衰竭,在人和实验动物中表现为舒张功能障碍,伴或不伴有收缩功能障碍。这项前瞻性研究的目的是确定新诊断为DM的猫是否存在心肌功能障碍,如果存在,在开始适当的抗糖尿病治疗后其是否会进展。32只糖尿病猫被纳入研究并接受了基线超声心动图检查;其中15只猫在6个月后再次接受检查。10只年龄和体重匹配的健康猫作为对照。与健康对照组相比,糖尿病猫在诊断时舒张功能降低,但收缩功能未降低,二尖瓣流入E波(E)和E/E'低于对照组。6个月后,与基线评估相比,糖尿病猫的E和E/IVRT'进一步降低。在排除6个月时DM缓解的猫后,胰岛素依赖型糖尿病猫的E、E/A和E'低于对照组。根据E/A和E'/A'对舒张功能进行分类时,6个月时出现向舒张功能受损模式的转变。6个月时所有胰岛素依赖型糖尿病猫的舒张功能均异常。这些结果表明,DM对猫和人类糖尿病患者的舒张功能有相似影响。尽管进行了抗糖尿病治疗,但6个月后功能障碍似乎仍在进展而非恢复正常。在患有心脏病的猫中,DM的发生可能是一个重要的额外健康风险。

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