Bertoni P D, Morandi G, Di Michele R, Canziani R
G Ital Cardiol. 1984 Nov;14(11):839-46.
Using digitized M-mode ecocardiography, 26 young subjects with type I diabetes mellitus of at least three years duration, without any clinical evidence of heart disease have been studied, searching for subclinical impairment of left ventricular function. Patients have been divided in two groups according to the presence (Group I, N degrees 7 patients) or absence (Group II, N degrees 19 patients) of retinopathy. The time interval from the shortest left ventricular diameter to the onset of mitral valve opening was significantly increased as compared with the control Group (10.20 +/- 8.88 control Group; 29.21 +/- 12.99 Group II, p less than 0.001; 41.00 +/- 12.29 Group I, p less than 0.001). Furthermore, a close correlation between the above named time interval and the duration of diabetes was found (r = 0.496, p less than 0.01). Finally, the change of left ventricular dimension during the time interval from the shortest left ventricular diameter to the onset of mitral valve opening, expressed as a percentage of left ventricular end-diastolic diameter, was increased (3.20 +/- 3.43 control Group; 8.21 +/- 5.51 Group II, p less than 0.02; 12.43 +/- 5.56 Group I, p less than 0.001). Our results suggest an impairment of ventricular relaxation due to increased wall stiffness. We conclude that there are often subclinical cardiac abnormalities in young diabetics resulting in impairment of diastolic function that is correlate with the duration of diabetes and with the presence of clinical complications such as retinopathy.
利用数字化M型超声心动图,对26名病程至少3年、无任何心脏病临床证据的1型糖尿病年轻受试者进行了研究,以寻找左心室功能的亚临床损害。根据是否存在视网膜病变,将患者分为两组(第一组,7例;第二组,19例)。与对照组相比,从左心室最短直径到二尖瓣开放开始的时间间隔显著延长(对照组为10.20±8.88;第二组为29.21±12.99,p<0.001;第一组为;41.00±12.29,p<0.001)。此外,发现上述时间间隔与糖尿病病程密切相关(r=0.496,p<0.01)。最后,从左心室最短直径到二尖瓣开放开始的时间间隔内左心室尺寸的变化,以左心室舒张末期直径的百分比表示,有所增加(对照组为3.20±3.43;第二组为8.21±5.51,p<0.02;第一组为12.43±5.56,p<0.001)。我们的结果提示由于心室壁硬度增加导致心室舒张功能受损。我们得出结论,年轻糖尿病患者常存在亚临床心脏异常,导致舒张功能受损,这与糖尿病病程以及视网膜病变等临床并发症的存在相关。