Diastolic dysfunction in normotensive men with well-controlled type 2 diabetes - Importance of maneuvers in echocardiographic screening for preclinical diabetic cardiomyopathy
Diastolic dysfunction in normotensive men with well-controlled type 2 diabetes - Importance of maneuvers in echocardiographic screening for preclinical diabetic cardiomyopathy
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DOI：
10.2337/diacare.24.1.5
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发表时间：
2001-01-01
期刊：
影响因子：
16.2
通讯作者：
Dumesnil, JG
中科院分区：
文献类型：
--
作者：
Poirier, P;Bogaty, P;Dumesnil, JG
目的-因为心室充盈的异常模式从来没有被认为是在研究中报告的患病率左心室舒张功能障碍（LVDD）之间的20和40%，我们的目的是更全面地评估患病率LVDD在subjects.RESEARCH设计和方法-我们研究了46名男性2型糖尿病谁是年龄38-67岁;无糖尿病并发症、高血压、冠状动脉疾病、充血性心力衰竭或甲状腺或明显肾病的证据;并且最大跑步机运动试验显示无缺血。多普勒超声心动图，其中包括使用的Valsalva动作和肺静脉记录，以揭露异常模式的左心室filling.RESULTS - LVDD被发现在28例（60%），其中13（28%）有异常模式的心室充盈和15（32%）有受损的松弛。所有受试者的心血管功能均正常，LVDD和代谢控制指标之间没有相关性。结论- LVDD比以前报道的控制良好的2型糖尿病患者更常见，他们没有临床可检测到的心脏病。这种现象在高风险人群中的高患病率表明，2型糖尿病LVDD筛查应包括Valsalva操作和肺静脉记录等程序，以揭示心室充盈的异常模式。
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 38-67 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 pseudonormal 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 high-risk 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.