Airaksinen K E, Ikäheimo M J, Salmela P I, Kirkinen P, Linnaluoto M K, Takkunen J T
Diabetes Care. 1986 Jul-Aug;9(4):376-83. doi: 10.2337/diacare.9.4.376.
To assess the adaptation of the heart of diabetic subjects in the natural volume overload state of pregnancy, echocardiography was performed during each trimester and postpartum in 17 women with insulin-dependent diabetes mellitus (IDDM) and in 11 healthy women. The mean duration of diabetes was 14 yr and signs of microvascular complications were detected in 6 patients. The diabetic women had slightly smaller left ventricles than the control women already in the basal state (postpartum), and the pregnancy-induced increase in left ventricular size and stroke volume was less in the diabetic than in the control women. The heart rate rise also tended to be less in the diabetic women, resulting in a markedly smaller increase in cardiac output in this group (1.3 vs. 3.4 L/min, P less than .01). Left ventricular systolic function, wall thicknesses, or left atrial size did not differ between the groups at any point in the study. Minor collections of pericardial fluid were observed in 14 (76%) diabetic women and in 5 (45%) control women during the second and/or third trimester, but only 2 diabetic women had classic pericardial effusions. In conclusion, the normal hemodynamic adjustments to pregnancy seem to be impaired in women with IDDM. Preclinical diabetic cardiomyopathy and autonomic neuropathy may be involved in the observed alterations.
为评估糖尿病患者在孕期自然血容量超负荷状态下心脏的适应性，对17例胰岛素依赖型糖尿病（IDDM）女性和11例健康女性在孕期各阶段及产后进行了超声心动图检查。糖尿病平均病程为14年，6例患者检测到微血管并发症迹象。糖尿病女性在基础状态（产后）时左心室就比对照女性略小，且孕期引起的左心室大小和每搏输出量增加在糖尿病女性中比对照女性少。糖尿病女性心率升高也往往较少，导致该组心输出量增加明显较小（1.3对3.4 L/分钟，P<0.01）。在研究的任何时间点，两组之间左心室收缩功能、室壁厚度或左心房大小均无差异。在孕中期和/或孕晚期，14例（76%）糖尿病女性和5例（45%）对照女性观察到少量心包积液，但只有2例糖尿病女性有典型的心包积液。总之，IDDM女性对妊娠的正常血流动力学调节似乎受损。临床前糖尿病性心肌病和自主神经病变可能与观察到的改变有关。
