Danielsen R, Nordrehaug J E, Lien E, Vik-Mo H
Am J Cardiol. 1987 Jul 1;60(1):143-6. doi: 10.1016/0002-9149(87)91001-0.
Noninvasive studies in patients with type 1 diabetes mellitus suggest subclinical left ventricular (LV) impairment, but the studies differ with regard to methods, patient selection and results. Thus, digitized M-mode echocardiograms were recorded in 24 persons younger than 50 years with long-term (more than 12 years) type 1 diabetes but without overt heart disease and in 28 control subjects. To improve accuracy, measurements were adjusted for body surface area, LV size and the influence of heart rate, as appropriate. Diabetics had a higher heart rate and systolic and diastolic blood pressure than control subjects. LV end-diastolic and stroke dimensions were smaller, duration of systole longer and preejection period/LV ejection time ratio higher than in control subjects, whereas fractional shortening and peak shortening rate were similar. In diabetics, diastole was shorter, peak filling rate was lower and the rapid filling period was prolonged, while percent filling during the rapid filling period and atrial contribution to filling were higher. Thus, in a well defined study population of relatively young persons with long-term type 1 diabetes, subclinical LV systolic and diastolic dysfunction were found. The diastolic abnormalities suggest reduced LV compliance, while those in systole may be secondary to an increased afterload or decreased myocardial contractility.
对1型糖尿病患者的无创性研究表明存在亚临床左心室（LV）损害，但这些研究在方法、患者选择和结果方面存在差异。因此，对24名年龄小于50岁、患有长期（超过12年）1型糖尿病但无明显心脏病的患者以及28名对照者记录了数字化M型超声心动图。为提高准确性，根据情况对测量值进行了体表面积、左心室大小和心率影响的校正。糖尿病患者的心率、收缩压和舒张压均高于对照者。与对照者相比，糖尿病患者的左心室舒张末期内径和每搏量较小，收缩期持续时间较长，射血前期/左心室射血时间比值较高，而缩短分数和峰值缩短率相似。在糖尿病患者中，舒张期较短，峰值充盈率较低，快速充盈期延长，而快速充盈期的充盈百分比和心房对充盈的贡献较高。因此，在一个明确界定的、相对年轻的长期1型糖尿病患者研究人群中，发现了亚临床左心室收缩和舒张功能障碍。舒张期异常提示左心室顺应性降低，而收缩期异常可能继发于后负荷增加或心肌收缩力降低。
