Impaired inotropic response in type 2 diabetes mellitus: A strain rate imaging study
Impaired inotropic response in type 2 diabetes mellitus: A strain rate imaging study
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DOI：
10.1016/j.amjhyper.2006.12.009
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发表时间：
2007-05-01
影响因子：
3.2
通讯作者：
de Divitiis, Oreste
中科院分区：
文献类型：
--
作者：
Galderisi, Maurizio;de Simone, Giovanni;de Divitiis, Oreste
背景资料：糖尿病心脏的左心室（LV）向心性几何结构和肥大，降低的室壁力学和异常舒张特性已被描述。然而，糖尿病患者对动态运动的心脏反应仍然存在争议。本研究评估多巴酚丁胺负荷时的应变率（SR）成像，探讨2型糖尿病患者的正性肌力反应，无冠状动脉disease.Methods：24例糖尿病患者和16例对照，均无冠状动脉疾病，在休息时和多巴酚丁胺负荷时进行多普勒超声心动图。结果：糖尿病患者左室质量和相对室壁厚度增加，室壁中部缩短减少，左室舒张功能异常。静息时，E-m显著降低，但两组之间的S-m、SR和应变相似。在低剂量和高剂量多巴酚丁胺时，糖尿病患者的S-m、SR和应变均显著降低，但无差异。在多巴酚丁胺的各个水平下，两组的应变均随心率（HR）的增加而增加（均P
Background: Left ventricular (LV) concentric geometry and hypertrophy, depressed wall mechanics, and abnormal diastolic properties have been described in the diabetic heart. However, the cardiac response to dynamic exercise in diabetic patients remains controversial. The present study assessed strain rate (SR) imaging during dobutamine stress, to investigate inotropic response in patients with type 2 diabetes mellitus and without coronary artery disease.Methods: Twenty-four diabetics and 16 controls, both free of coronary artery disease, underwent Doppler echocardiography at rest and during dobutamine stress. Tissue Doppler systolic (S-m) and early diastolic (E-m) velocities, SR, and strain of middle posterio r septum were measured at rest, low-dose, and high-dose dobutamine.Results: Diabetics had higher LV mass and relative wall thickness, lower midwall shortening, and transmittal pattern of abnormal LV relaxation. At rest, E-m was significantly lower but S-m, SR, and strain were similar between the two groups. At low-dose and high-dose dobutamine, without difference of S-m, SR and strain were significantly lower in diabetics. At every level of dobutamine, strain increased with increasing heart rate (HR) in either group (both P