Government Institution "Scientific Practical Medical Centre for Pediatric Cardiology and Cardiac Surgery of Ukraine" Clinic for adults, Yuriy Illienko 24, 04050 Kyiv, Ukraine.
Government Institution "Scientific Practical Medical Centre for Pediatric Cardiology and Cardiac Surgery of Ukraine" Clinic for adults, Yuriy Illienko 24, 04050 Kyiv, Ukraine.
J Diabetes Complications. 2023 Nov;37(11):108519. doi: 10.1016/j.jdiacomp.2023.108519. Epub 2023 Jun 2.
To investigate the relationship between glycemic variability (GV) and diastolic dysfunction in patients with type 2 diabetes mellitus (DM) without coronary artery disease.
Seventy-eight patients with type 2 DM without coronary artery disease were enrolled into the study. Diastolic function was assessed by echocardiography (Philips IE33); GV was evaluated by continuous monitoring of glucose (CGM, Guardian™ Connect System, Medtronic). According to the GV all studied patients were divided into two groups: group I - standard deviation (SD) > 2 (high GV), n = 40; group II - SD ≤ 1.9 (normal GV), n = 38.
Group I were older (49±9 vs 46±5; p<0.05), with a longer duration of DM (10±9.5 vs 6±5.5; p<0.01). Patients in group I had more severe diastolic dysfunction which was characterized by an increased values of myocardial stiffness index (E/e' ratio), speed of early transmitral flow (E, sm/sec) and peak rate of tricuspid regurgitation (V max TR, m/sec). Multivariate regression analysis revealed that high GV and older age of patients were the only significant independent predictors for diastolic dysfunction.
Increased GV is associated with diastolic dysfunction and could predispose to development and progression of heart failure in patients with type 2 DM without coronary arteries disease.
探讨 2 型糖尿病（DM）患者血糖变异性（GV）与舒张功能障碍的关系，这些患者无冠状动脉疾病。
本研究纳入 78 例无冠状动脉疾病的 2 型 DM 患者。通过超声心动图（Philips IE33）评估舒张功能；通过连续监测血糖（CGM，Medtronic 的 Guardian™ Connect System）评估 GV。根据 GV，所有研究患者被分为两组：I 组 - 标准差（SD）> 2（高 GV），n = 40；II 组 - SD ≤ 1.9（正常 GV），n = 38。
I 组年龄较大（49±9 岁比 46±5 岁；p<0.05），DM 病程较长（10±9.5 岁比 6±5.5 岁；p<0.01）。I 组患者舒张功能障碍更严重，表现为心肌僵硬度指数（E/e' 比值）、早期二尖瓣血流速度（E，sm/sec）和三尖瓣反流峰值速度（V max TR，m/sec）值升高。多变量回归分析显示，高 GV 和患者年龄较大是舒张功能障碍的唯一显著独立预测因素。
GV 增加与舒张功能障碍有关，并可能使无冠状动脉疾病的 2 型 DM 患者易发生心力衰竭的发展和进展。
