Shapiro L M, Leatherdale B A, Mackinnon J, Fletcher R F
Br Heart J. 1981 Feb;45(2):129-32. doi: 10.1136/hrt.45.2.129.
We have shown a close relation between clinical microvascular complications and abnormalities of left ventricular function in 185 established diabetics without clinical heart disease. In 50 insulin-dependent diabetics who presented at under 20 years of age there was a correlation between the duration of diabetes and the isovolumic relaxation time, minimal dimension to mitral valve opening, and ratio of pre-ejection period to left ventricular ejection time. Diabetics with mild microvascular complications were similar to diabetics with no complications except for minor prolongation of the diastolic time intervals. Those with severe complications were significantly different from diabetes with milder complications and normal controls in all variables of left ventricular function. A close relation between left ventricular function and the microvascular complications index (code 0 when no complications to code 7 when all present and severe) was found for the following variables: isovolumic relaxation time, the interval from minimal dimension to mitral valve opening, ratio of pre-ejection period to left ventricular ejection time, and pre-ejection period index. It is concluded that in diabetes abnormalities of left ventricular function are related to duration of disease and complications; and that a diabetic specific heart muscle disorder occurs frequently in patients with severe microvascular complications.
我们已证实，在185例无临床心脏病的确诊糖尿病患者中，临床微血管并发症与左心室功能异常之间存在密切关系。在50例20岁以下发病的胰岛素依赖型糖尿病患者中，糖尿病病程与等容舒张时间、二尖瓣开放时最小内径以及射血前期与左心室射血时间之比之间存在相关性。除舒张期时间间隔略有延长外，轻度微血管并发症的糖尿病患者与无并发症的糖尿病患者相似。在左心室功能的所有变量方面，严重并发症患者与轻度并发症患者及正常对照组有显著差异。对于以下变量，发现左心室功能与微血管并发症指数（无并发症为0分，所有并发症且严重时为7分）之间存在密切关系：等容舒张时间、从最小内径到二尖瓣开放的时间间隔、射血前期与左心室射血时间之比以及射血前期指数。结论是，在糖尿病中，左心室功能异常与病程及并发症有关；并且在严重微血管并发症患者中，常发生糖尿病特异性心肌疾病。
