Nicolino A, Longobardi G, Furgi G, Rossi M, Zoccolillo N, Ferrara N, Rengo F
Fondazione Clinica del Lavoro, IRCCS, Divisione di Cardiologia, Italy.
Am J Hypertens. 1995 Apr;8(4 Pt 1):382-9. doi: 10.1016/0895-7061(95)00022-h.
Left ventricular diastolic filling by Doppler echocardiography was investigated in 84 diabetic patients without evidence of heart disease and in 84 normotensive nondiabetic age- and sex-matched control subjects. Diabetic patients were subdivided into two groups on the basis of the presence of arterial hypertension. Group 1 comprised 41 normotensive diabetic patients (19 men, 22 women, mean age 63.7 +/- 9.1 years); Group 2 comprised 43 hypertensive diabetics (15 men, 28 women, mean age 65.6 +/- 9.6 years). Doppler measures of diastolic filling were significantly altered in the two groups as compared with control subjects. Peak atrial flow velocity, velocity integral for the atrial filling period, and atrial filling fraction were increased, whereas the ratio of peak early to peak atrial flow velocity and the ratio of flow velocity integrals were decreased, especially in Group 2 patients. Thirteen patients in Group 1 (32%) and 17 in Group 2 (40%) had evidence of diastolic dysfunction, as assessed by the presence of at least two independent abnormal indices (outside age-corrected 95% confidence interval). In each group, patients with altered diastolic filling differed slightly from diabetic patients with normal Doppler indices, tending to increased wall thickness and left ventricular mass. In conclusion, diastolic filling of the left ventricle is frequently altered in diabetic patients and is adversely affected by arterial hypertension whose coexistence further impairs left ventricular relaxation.
通过多普勒超声心动图对84例无心脏病证据的糖尿病患者和84例年龄及性别匹配的血压正常的非糖尿病对照者的左心室舒张期充盈情况进行了研究。根据是否存在动脉高血压，将糖尿病患者分为两组。第1组包括41例血压正常的糖尿病患者（19例男性，22例女性，平均年龄63.7±9.1岁）；第2组包括43例高血压糖尿病患者（15例男性，28例女性，平均年龄65.6±9.6岁）。与对照者相比，两组的舒张期充盈的多普勒测量值均有显著改变。心房血流峰值速度、心房充盈期速度积分和心房充盈分数增加，而早期峰值与心房峰值血流速度之比以及速度积分之比降低，尤其是在第2组患者中。根据至少两个独立异常指标的存在情况（超出年龄校正后的95%置信区间）评估，第1组有13例患者（32%），第2组有17例患者（40%）存在舒张功能障碍的证据。在每组中，舒张期充盈改变的患者与多普勒指标正常的糖尿病患者略有不同，往往表现为心室壁厚度和左心室质量增加。总之，糖尿病患者左心室舒张期充盈常发生改变，且受到动脉高血压的不利影响，二者并存会进一步损害左心室舒张功能。
