Rubler S, Fisher V J
Clin Cardiol. 1985 Dec;8(12):621-8. doi: 10.1002/clc.4960081203.
This study was conducted with asymptomatic middle-aged male subjects with diabetes mellitus to detect latent cardiac disease using noninvasive techniques. One group of 38 diabetic males (mean age 50.5 +/- 10.2 years) and a group of 15 normal males (mean age 46.9 +/- 10.0 years) participated in the initial trial; 13 diabetic patients and 7 control subjects were restudied 1-2 years later. Maximal treadmill exercise with a Bruce protocol and myocardial scintigraphy with thallium-201(201Tl) were used. Diabetic subjects on initial examination and retesting achieved a lower maximal heart rate and duration of exercise than control subjects. Abnormal electrocardiographic changes, thallium defects, or both were observed in 23/38 diabetic males (60.5%) on the first study and only one 65-year-old control subject had such findings. On retesting, the control subjects had no abnormalities while 76.9% of diabetic subjects had either 201Tl defects or ECG changes. We conclude that despite the fact that none of diabetic males had any clinical evidence or symptoms of heart disease, this high-risk group demonstrated abnormalities on exercise testing that merit careful subsequent evaluation and followup and could be an effective method of detecting early cardiac disease.
本研究针对无症状的中年男性糖尿病患者，采用无创技术检测潜在的心脏疾病。38名糖尿病男性（平均年龄50.5±10.2岁）和15名正常男性（平均年龄46.9±10.0岁）参与了初始试验；1 - 2年后，对13名糖尿病患者和7名对照受试者进行了再次研究。采用布鲁斯方案进行最大运动平板试验，并使用铊 - 201（²⁰¹Tl）进行心肌闪烁显像。糖尿病受试者在初次检查和再次检测时，其最大心率和运动持续时间均低于对照受试者。在首次研究中，23/38（60.5%）的糖尿病男性观察到心电图异常改变、铊缺损或两者皆有，而仅有一名65岁的对照受试者有此类发现。再次检测时，对照受试者无异常，而76.9%的糖尿病受试者存在²⁰¹Tl缺损或心电图改变。我们得出结论，尽管这些糖尿病男性均无心脏病的临床证据或症状，但这一高危人群在运动试验中表现出异常，值得后续仔细评估和随访，且这可能是检测早期心脏病的有效方法。
