[Silent myocardial ischemia in patients with diabetes mellitus without the clinical manifestations of ischemic heart disease].

A total of 40 patients with diabetes mellitus without anginal episodes and equivalents were studied. 24-hour monitoring identified 2 groups of patients: (1) 13 patients with recorded silent myocardial ischemic episodes and (2) 23 patients without episodes. Four patients were found to have stress-echocardiographic silent myocardial ischemia. Silent myocardial ischemia was detected in 42.5% of patients with diabetes mellitus. The patients from Group 1 exhibited more frequently Type II diabetes mellitus whose duration was over 9 years and concurrent retino- and polyneuropathies. There was a relationship between silent myocardial ischemia to heart failure and myocardial hypertrophy as evidenced by two-dimensional echocardiography. The patients from Group 1 had a higher pain sensitivity threshold than those from Group 2. Autonomic polyneuropathy was observed in 46% of Group 1 patients and in 21% of Group 2 patients.