Seneviratne B I
Br Med J. 1977 Jun 4;1(6074):1444-6. doi: 10.1136/bmj.1.6074.1444.
Left ventricular function was assessed by measuring sytolic time intervals in insulin-requiring diabetics with and without significant microangiopathy. The results were compared with those in normal controls. Significant microangiopathy was defined as proteinuria over 3 g/24 h or proliferative retinopathy. Left ventricular function was also assessed one and a half years later by echocardiography in four patients with microangiopathy. Patients with angina, previous myocardial infarction, hypertension, and alcoholism were excluded. All had normal electrocardiograms and chest radiographs. Diabetics with microangiopathy had impaired left ventricular function, whereas those with uncomplicated diabetes had normal function. This finding supports the existence of a specific diabetic cardiomyopathy due to microangiopathy rather than the metabolic defect. The association of microangiopathy and impaired left ventricular function may explain the high immediate mortality and the high incidence of cardiogenic shock and congestive heart failure after myocardial infarction in diabetics.
通过测量需要胰岛素治疗的糖尿病患者（有无明显微血管病变）的收缩期时间间期来评估左心室功能。将结果与正常对照组进行比较。明显微血管病变定义为蛋白尿超过3 g/24小时或增殖性视网膜病变。对4例有微血管病变的患者在一年半后也通过超声心动图评估左心室功能。排除有胸痛、既往心肌梗死、高血压和酗酒的患者。所有患者心电图和胸部X线片均正常。有微血管病变的糖尿病患者左心室功能受损，而无并发症的糖尿病患者功能正常。这一发现支持存在一种由微血管病变而非代谢缺陷导致的特定糖尿病性心肌病。微血管病变与左心室功能受损之间的关联可能解释了糖尿病患者心肌梗死后较高的即刻死亡率以及心源性休克和充血性心力衰竭的高发病率。
