Shapiro L M
Br Heart J. 1982 May;47(5):439-44. doi: 10.1136/hrt.47.5.439.
In order to study left ventricular diastolic function in diabetes mellitus, simultaneous echo- and phonocardiograms were recorded in 142 diabetics (free from heart disease), 20 normal subjects, and 16 patients with coronary artery disease. The resultant traces were digitised, and left ventricular relaxation and the rate and duration of cavity dimension increase and wall thinning were determined. Diastolic variables of left ventricular function were normal in 12 young diabetics with no complications. Significantly delayed mitral valve opening relative to minimum dimension and aortic valve closure was found in all other groups of diabetics. Forty-four diabetics with severe microvascular complications had significantly reduced peak rate and prolonged duration of wall thinning and dimension increase. The abnormalities were unlike those found in subjects with coronary artery disease. The extent of microvascular complications was significantly correlated to most variables of diastolic function. This relation was maintained in 31 diabetics with significant cavity dimension increase during isovolumic relaxation (incoordinate relaxation). In 42 juvenile onset patients there was good correlation between the duration of diabetes and most variables of diastolic function. These studies show that the primary cardiac abnormality in diabetic micro-angiography is a prolonged duration and reduced rate of posterior wall thinning with impaired left ventricular dimension increase, reflecting abnormal myocardial properties.
为研究糖尿病患者的左心室舒张功能，对142例（无心脏病）糖尿病患者、20例正常受试者和16例冠状动脉疾病患者同时记录了超声心动图和心音图。将所得记录数字化，并测定左心室舒张、腔径增加速率和持续时间以及室壁变薄情况。12例无并发症的年轻糖尿病患者左心室功能的舒张变量正常。在所有其他糖尿病患者组中，相对于最小腔径和主动脉瓣关闭，二尖瓣开放明显延迟。44例有严重微血管并发症的糖尿病患者，室壁变薄和腔径增加的峰值速率显著降低，持续时间延长。这些异常与冠状动脉疾病患者不同。微血管并发症的程度与舒张功能的大多数变量显著相关。在31例等容舒张期腔径显著增加（不协调舒张）的糖尿病患者中，这种关系依然存在。在42例青少年发病患者中，糖尿病病程与舒张功能的大多数变量之间有良好的相关性。这些研究表明，糖尿病微血管病变时的原发性心脏异常是后壁变薄持续时间延长、速率降低，左心室腔径增加受损，反映了心肌特性异常。
