Fiorini G, Scotti L A, Parmigiani M L, Ferrari M, Pezzoli P, Bignotti G
Divisione di Medicina, Ospedale Uboldo, Cernusco sul Naviglio, MI.
G Ital Cardiol. 1995 Jan;25(1):17-25.
To evaluate left ventricular diastolic function by Doppler echocardiography in patients with type 2 (non-insulin-dependent) diabetes mellitus, without coronary artery disease.
Previous studies suggest that the velocity curve obtained by Doppler echocardiography of the mitral inflow may reflect the filling pattern of the left ventricle.
To evaluate the presence of diastolic impairment of the left ventricle in diabetic patients without evidence of coronary artery disease, 30 patients with non-insulin-dependent diabetes mellitus and 20 normal control subjects underwent M-mode, two-dimensional (2-D) and Doppler echocardiography. In the group of diabetic patients (Diabetics), the peak E wave velocity was 0.70 +/- 0.11 m/sec, while in the control group (Controls) it was 1.1 +/- 0.23 m/sec (mean values, +SD, p < 0.001). The peak A wave velocity was 0.89 +/- 0.17 in Diabetics, versus 0.60 +/- 0.34 in Controls. Consequently, E/A ratio was 0.81 +/- 0.18 in Diabetics, versus 1.73 +/- 0.29 in Controls (p < 0.001). Isovolumic relaxation time was 0.08 +/- 0.021 sec in Diabetics, while in Controls it was 0.04 +/- 0.02 sec (p < 0.001). Left atrium diameter was 41 +/- 11 mm in Diabetics, and 37 +/- 4 mm in Controls (p = NS). Left ventricular volumes, ejection fraction, interventricular septal and posterior wall thickness were similar in both groups. No correlation was found between diabetes duration and diastolic function indexes. In Diabetics no correlation was found between age and E/A ratio (correlation coefficient +/- 0.11) while in Controls E/A ratio was lower in the older subjects (r = +/- 0.75). This ratio was 1.89 +/- 0.20 in Controls aged < 65 years, and 1.6 +/- 0.33 in Controls aged > or = 65 years. (p = 0.06). These data suggest that 1) E/A ratio and isovolumic relaxation time are significantly altered in non-insulin-dependent diabetic patients without coronary artery disease; 2) Doppler echocardiography is a useful technique to detect left ventricular diastolic impairment; 3) diastolic impairment seems not to correlate with disease duration; 4) systolic function is normal in our group of type 2 diabetic patients.
通过多普勒超声心动图评估无冠状动脉疾病的2型（非胰岛素依赖型）糖尿病患者的左心室舒张功能。
先前的研究表明，通过二尖瓣血流多普勒超声心动图获得的速度曲线可能反映左心室的充盈模式。
为评估无冠状动脉疾病证据的糖尿病患者左心室舒张功能障碍的存在情况，对30例非胰岛素依赖型糖尿病患者和20例正常对照者进行了M型、二维（2-D）和多普勒超声心动图检查。在糖尿病患者组（糖尿病组）中，E波峰值速度为0.70±0.11米/秒，而在对照组中为1.1±0.23米/秒（平均值，±标准差，p<0.001）。糖尿病组A波峰值速度为0.89±0.17，对照组为0.60±0.34。因此，糖尿病组E/A比值为0.81±0.18，对照组为1.73±0.29（p<0.001）。糖尿病组等容舒张时间为0.08±0.021秒，对照组为0.04±0.02秒（p<0.001）。糖尿病组左心房直径为41±11毫米，对照组为37±4毫米（p=无显著性差异）。两组左心室容积、射血分数、室间隔和后壁厚度相似。未发现糖尿病病程与舒张功能指标之间存在相关性。在糖尿病组中，未发现年龄与E/A比值之间存在相关性（相关系数±0.11），而在对照组中，年龄较大的受试者E/A比值较低（r=±0.75）。年龄<65岁的对照组该比值为1.89±0.20，年龄≥65岁的对照组为1.6±0.33（p=0.06）。这些数据表明：1）无冠状动脉疾病的非胰岛素依赖型糖尿病患者的E/A比值和等容舒张时间显著改变；2）多普勒超声心动图是检测左心室舒张功能障碍的有用技术；3）舒张功能障碍似乎与病程无关；4）我们的2型糖尿病患者组的收缩功能正常。
