Left ventricular function in insulin-dependent and in non-insulin-dependent diabetic patients: Radionuclide assessment
Left ventricular function in insulin-dependent and in non-insulin-dependent diabetic patients: Radionuclide assessment
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DOI：
10.1159/000177322
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发表时间：
1997-03-01
期刊：
影响因子：
1.9
通讯作者：
Magnati, G
中科院分区：
文献类型：
--
作者：
Astorri, E;Fiorina, P;Magnati, G
本研究的目的是比较，通过门控放射性核素血管造影，收缩和舒张功能的胰岛素依赖型（IDDM）和非胰岛素依赖型（NIDDM）糖尿病患者没有明显的心血管疾病。研究人群包括20名IDDM患者（15名男性，5名女性; 40.7 ± 10.3岁），14名NIDDM患者（9名男性，5名女性; 47.0 ± 7.5岁）和12名健康受试者（7名男性，5名女性; 41.5 ± 6.3岁）作为对照（C）组。IDDM患者的糖尿病病程（DD）和糖化血红蛋白（HbA（1C））水平显著高于对照组。门控核素左心室造影测定的心室射血分数和峰值射血率（PER）在三组中相似，而峰值充盈率（PFR）在NIDDM患者中低于IDDM患者（p < 0.05）和对照健康受试者（P < 0.01），胰岛素依赖型糖尿病= 3.39 ± 1.14;非胰岛素依赖型糖尿病= 2.65 ± 0.83; C = 3.55 +/- 0.73），NIDDM组的PFR时间显著长于IDDM组（p < 0.05）和C组（p < 0.05，NIDDM = 162 +/-26; IDDM = 140 +/-28; C = 142 +/-23）。PFR/PER比值在胰岛素依赖型糖尿病患者和对照组中接近正常值（接近或等于1），而在非胰岛素依赖型糖尿病患者中降低（接近或等于=0.84 ± 0.18）。7例IDDM和4例NIDDM患者有心血管自主神经病变的临界体征，与DD、HbA（1C）和心电图参数无关。左心室收缩功能基本正常，在两个胰岛素依赖型糖尿病和非胰岛素依赖型糖尿病患者相似。NIDDM患者的心室舒张充盈受损，表现为PFR降低，尤其是PFR/PER比值降低。我们的放射性核素数据表明，非胰岛素依赖型糖尿病患者有一个普遍的心室舒张功能异常，相对于胰岛素依赖型糖尿病患者，虽然后者患者有较高的DD和HbA（1C）值。
The aim of this study was to compare, by gated radionuclide angiography, systolic and diastolic ventricular function in insulin-dependent (IDDM) and non-insulin-dependent (NIDDM) diabetic patients without overt cardiovascular disease. The study population consisted of 20 IDDM patients (15 male, 5 female; 40.7 +/- 10.3 years), 14 NIDDM patients (9 male, 5 female; 47.0 +/- 7.5 years) and 12 healthy subjects (7 male, 5 female; 41.5 +/- 6.3 years) as a control (C) group. The duration of diabetes (DD) and glycosylated hemoglobin (HbA(1C)) levels were significantly higher in the IDDM patients. The ventricular ejection fraction and peak ejection rate (PER) were assessed by gated radionuclide left ventriculography and were similar in three groups, while the peak filling rate (PFR) was lower in the NIDDM patients compared to the IDDM patients (p < 0.05) and controlled healthy subjects (p < 0.01, IDDM = 3.39 +/- 1.14; NIDDM = 2.65 +/- 0.83; C = 3.55 +/- 0.73), the time to PFR was significantly more prolonged in the NIDDM group than in the IDDM (p < 0.05) and C groups (p < 0.05, NIDDM = 162 +/- 26; IDDM = 140 +/- 28; C = 142 +/- 23). The PFR/PER ratio was near the normal value (similar or equal to 1) in the IDDM patients and controlled subjects, while in the NIDDM patients it was reduced (similar or equal to=0.84 +/- 0.18). Seven IDDM and 4 NIDDM patients had borderline signs of cardiovascular autonomic neuropathy, unrelated to DD, HbA(1C) and scintigraphic parameters. Left ventricular systolic performance was substantially normal and similar in both the IDDM and NIDDM patients. Ventricular diastolic filling was impaired in the NIDDM patients, as shown by the decrease in PFR and in particular in the PFR/PER ratio. Our radionuclide data suggest that the NIDDM patients had a prevalent abnormality of ventricular diastolic performance, with respect to the IDDM patients, although the latter patients had higher DD and HbA(1C) values.