Gough S C, Smyllie J, Barker M, Berkin K E, Rice P J, Grant P J
Diabetes and Thrombosis Research Group, University of Leeds, UK.
Acta Diabetol. 1995 Jun;32(2):110-5. doi: 10.1007/BF00569568.
Diastolic dysfunction may be the earliest marker of a diabetes-induced heart muscle disease which leads to the progressive development of cardiac failure. Left ventricular diastolic function was indirectly assessed using pulsed wave Doppler ultrasound mitral-flow velocities in 20 normotensive patients with a new diagnosis of type 2 diabetes mellitus, normal cardiac function and no evidence of coronary artery disease and in 16 age-matched normal subjects. Peak velocities of early (E) and late (A) left ventricular filling were measured. The median (interquartile ranges) peak E/A ratio was significantly reduced in the diabetic group 0.96 (0.8-1.2) vs 1.2 (1.1-1.3), P < 0.01. Despite improvements in glycaemic control over 3 months, HbA1c 9.9% (7.6%-10.5%) to 7.4% (6.5%-7.9%), P < 0.001, maintained at 6 months, HbA1c 7.0% (6.4%-7.3%), there were no changes in the E/A ratio, 0.96 (0.83-1.15) and 0.95 (0.83-1.17), respectively. Furthermore, there was no correlation between percentage change in HbA1c and E/A ratio over 6 months. The results of this study suggest that in patients with type 2 diabetes mellitus and normal systolic function, diastolic function was impaired at diagnosis and was not affected by an improvement in the glycaemic control.
舒张功能障碍可能是糖尿病诱发的心肌病的最早标志，这种心肌病会导致心力衰竭的逐步发展。在20名新诊断为2型糖尿病、心功能正常且无冠状动脉疾病证据的血压正常患者以及16名年龄匹配的正常受试者中，使用脉冲波多普勒超声测量二尖瓣血流速度间接评估左心室舒张功能。测量左心室早期（E）和晚期（A）充盈的峰值速度。糖尿病组的E/A峰值比中位数（四分位间距）显著降低，分别为0.96（0.8 - 1.2）和1.2（1.1 - 1.3），P < 0.01。尽管在3个月内血糖控制有所改善，糖化血红蛋白从9.9%（7.6% - 10.5%）降至7.4%（6.5% - 7.9%），P < 0.001，且在6个月时维持在7.0%（6.4% - 7.3%），但E/A比值没有变化，分别为0.96（0.83 - 1.15）和0.95（0.83 - 1.17）。此外，6个月内糖化血红蛋白的变化百分比与E/A比值之间没有相关性。本研究结果表明，在2型糖尿病且收缩功能正常的患者中，舒张功能在诊断时即受损，且不受血糖控制改善的影响。
