Fraser G E, Luke R, Thompson S, Smith H, Carter S, Sharpe N
Department of Medicine, University of Auckland, New Zealand.
Am J Cardiol. 1995 Jan 15;75(2):141-5. doi: 10.1016/s0002-9149(00)80063-6.
This report compares echocardiographic estimates of systolic and diastolic function and ventricular dimensions in type I diabetics and normal controls. A random sample of 60 diabetics selected from a central hospital diabetic clinic was compared with a sample of 40 nondiabetic controls, and matched to the diabetics by age, gender, and blood pressure. Simple comparisons showed that diabetics had a higher mean resting heart rate (HR) (p < 0.001) and a slower diastolic early filling phase (maximal rate of increase in left ventricular dimension in early diastole [v/dtmax], p = 0.08; time from end-systole until dv/dtmax [ES-dv/dtmax], p = 0.03), which were explained by differences in HR and other factors. Resting HR was significantly associated with several echocardiographic variables, but the slope relating resting HR to ventricular dimension was more negative in diabetics than in controls (end-diastolic diameter, p < 0.008; end-systolic diameter, p < 0.005), and the ratio of systolic to diastolic duration was significantly (p < 0.01) less positive in diabetics. The association of resting HR to duration of isovolumic diastole was positive in diabetics and negative in controls (p < 0.02). Among diabetics, those with higher resting HR had more retinopathy (p < 0.05), microalbuminuria (p < 0.05), smaller ventricles (p < 0.01), and longer isovolumic diastole (p < 0.05). Poorer diabetic control was associated with poorer systolic (fractional shortening, p < 0.05) and diastolic (dv/dtmax, p < 0.05; ES-dv/dtmax, p < 0.05) function.(ABSTRACT TRUNCATED AT 250 WORDS)
本报告比较了I型糖尿病患者和正常对照者的收缩和舒张功能以及心室大小的超声心动图评估结果。从一家中心医院糖尿病诊所选取60名糖尿病患者的随机样本,与40名非糖尿病对照者样本进行比较,并按年龄、性别和血压与糖尿病患者进行匹配。简单比较显示,糖尿病患者静息心率(HR)较高(p < 0.001),舒张早期充盈阶段较慢(舒张早期左心室大小最大增加率[v/dtmax],p = 0.08;从收缩末期到dv/dtmax的时间[ES - dv/dtmax],p = 0.03),这可由心率和其他因素的差异来解释。静息心率与多个超声心动图变量显著相关,但糖尿病患者中静息心率与心室大小的斜率比对照者更负(舒张末期直径,p < 0.008;收缩末期直径,p < 0.005),且糖尿病患者中收缩期与舒张期持续时间的比值显著更不正值(p < 0.01)。糖尿病患者中静息心率与等容舒张期持续时间的关联为正,而对照者中为负(p < 0.02)。在糖尿病患者中,静息心率较高者有更多视网膜病变(p < 0.05)、微量白蛋白尿(p < 0.05)、较小的心室(p < 0.01)和更长的等容舒张期(p < 0.05)。糖尿病控制较差与较差的收缩功能(缩短分数,p < 0.05)和舒张功能(dv/dtmax,p < 0.05;ES - dv/dtmax,p < 0.05)相关。(摘要截选至250字)