CLINICALLY UNRECOGNIZED VENTRICULAR DYSFUNCTION IN YOUNG DIABETIC-PATIENTS
CLINICALLY UNRECOGNIZED VENTRICULAR DYSFUNCTION IN YOUNG DIABETIC-PATIENTS
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DOI：
10.1016/s0735-1097(84)80207-7
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发表时间：
1984-01-01
影响因子：
24
通讯作者：
MCLAUGHLIN, PR
中科院分区：
文献类型：
--
作者：
MILDENBERGER, RR;BARSHLOMO, B;MCLAUGHLIN, PR
对20例糖尿病患者和18例无心脏病临床证据的正常对照进行静息和仰卧自行车运动时左心室功能的门控核素血管造影。糖尿病患者年龄21 ~ 44岁，除1例外均使用胰岛素。没有受试者在运动过程中出现胸痛或心电图改变。两组的休息和锻炼心率和血压相似，工作负荷也相似。对照组在休息时的射血分数为65.4±。6.2%(平均+-。18人中只有1人在运动后出现下降。峰值运动射血分数平均为77.1±。7.8%。糖尿病组的平均射血分数为63.7 +-。6.5%，与对照组相似，但20人中有7人在运动期间出现下降。运动射血分数平均为67.7±。9.7%，显著低于对照组（P < 0.01）。糖尿病患者对运动的射血分数反应差异很大，从增加25%到减少21%不等。这种反应与年龄、性别、糖尿病病程、吸烟、视网膜病变、运动心率、血压或心率压产物、达到的工作量或休息时的射血分数无关。大约1/3的糖尿病患者有亚临床左心室功能障碍，与动脉粥样硬化或其他糖尿病并发症的危险因素无关。这是由于未被识别的冠状动脉疾病还是原发性心肌疾病，目前尚不清楚。
Left ventricular function at rest and during supine bicycle exercise was assessed by gated radionuclide angiography in 20 diabetic patients and 18 normal control subjects without clinical evidence of heart disease. The diabetic patients were aged 21-44 yr and all except 1 used insulin. No subject developed chest pain or ECG changes during exercise. Both groups had a similar rest and exercise heart rate and blood pressure, and both achieved similar work loads. The control group had an ejection fraction at rest of 65.4 .+-. 6.2% (mean .+-. SD) and only 1 of 18 showed a decrease with exercise. Peak exercise ejection fraction averaged 77.1 .+-. 7.8%. The diabetic group had a mean ejection fraction at rest of 63.7 .+-. 6.5%, similar to that of the control group, but 7 of 20 showed a decrease during exercise. The exercise ejection fraction averaged 67.7 .+-. 9.7%, significantly lower than that of the control group (P < 0.01). The diabetic patients varied widely in ejection fraction response to exercise, ranging from an increase of 25% to a decrease of 21%. This response did not correlate with age, sex, duration of diabetes, smoking, retinopathy, exercise heart rate, blood pressure or rate-pressure product, work load attained or ejection fraction at rest. Approximately 1/3 of patients with diabetes have subclinical left ventricular dysfunction without correlation to risk factors for atherosclerosis or other diabetic complications. Whether this is due to unrecognized coronary artery disease or primary myocardial disease remains unknown.