Vol 2, No 2 (2001): Practical Diabetology
Other materials agreed with the Editors
Published online: 2001-03-08
Diastolic dysfunction in normotensive men well-controlled type 2 diabetes
Diabetologia Praktyczna 2001;2(2):159-166.
Abstract
OBJECTIVE. Because a pseudonormal pattern of ventricular
filling has never been considered in studies that
reported a prevalence of left ventricular diastolic dysfunction
(LVDD) between 20 and 40%, our aim was to
more completely evaluate the prevalence of LVDD in
subjects with diabetes.
RESEARCH DESIGN AND METHODS. We studied 46 men with type 2 diabetes who were aged 3867 years; without evidence of diabetic complications, hypertension, coronary artery disease, congestive heart failure, or thyroid or overt renal disease; and with a maximal treadmill exercise test showing no ischemia. LVDD was evaluated by Doppler echocardiography, which included the use of the Valsalva maneuver and pulmonary venous recordings to unmask a pseudonormal pattern of left ventricular filling.
RESULTS. LVDD was found in 28 subjects (60%), of whom 13 (28%) had a pseudo-normal pattern of ventricular filling and 15 (32%) had impaired relaxation. Systolic function was normal in all subjects, and there was no correlation between LVDD and indexes of metabolic control.
CONCLUSIONS. LVDD is much more common than previously reported in subjects with well-controlled type 2 diabetes who are free of clinically detectable heart disease. The high prevalence of this phenomenon in this highrisk population suggests that screening for LVDD in type 2 diabetes should include procedures such as the Valsalva maneuver and pulmonary venous recordings to unmask a pseudonormal pattern of ventricular filling.
RESEARCH DESIGN AND METHODS. We studied 46 men with type 2 diabetes who were aged 3867 years; without evidence of diabetic complications, hypertension, coronary artery disease, congestive heart failure, or thyroid or overt renal disease; and with a maximal treadmill exercise test showing no ischemia. LVDD was evaluated by Doppler echocardiography, which included the use of the Valsalva maneuver and pulmonary venous recordings to unmask a pseudonormal pattern of left ventricular filling.
RESULTS. LVDD was found in 28 subjects (60%), of whom 13 (28%) had a pseudo-normal pattern of ventricular filling and 15 (32%) had impaired relaxation. Systolic function was normal in all subjects, and there was no correlation between LVDD and indexes of metabolic control.
CONCLUSIONS. LVDD is much more common than previously reported in subjects with well-controlled type 2 diabetes who are free of clinically detectable heart disease. The high prevalence of this phenomenon in this highrisk population suggests that screening for LVDD in type 2 diabetes should include procedures such as the Valsalva maneuver and pulmonary venous recordings to unmask a pseudonormal pattern of ventricular filling.
Keywords: diabetic cardiomiopathydiastolic functiontype 2 diabetes