Korean J Med.  2002 Apr;62(4):422-429.

Impairment of diastolic function in newly diagnosed non-insulin-dependent diabetes mellitus

• Cha YS
• Choi HY
• Park JK
• Lee J
• Lim SW
• Cha DH
• Hong EK
• Park SW
• Kim YL
• Cho YW
• Lee SJ

Abstract

BACKGROUND
Heart failure is one of the major cause of premature mortality and morbidity in diabetes mellitus. It has been well recognized that left ventricular diastolic dysfunction caused by autonomic neuropathy, hyperinsulinemia, hyperlipidemia might be a preceding underlying mechanism of heart failure in diabetes. Also, an impairment of diastolic function in early diabetic patients has been reported in some literature. So, we evaluated the diastolic function in newly diagnosed diabetics with echocardiography.
METHODS
All patients with newly diagnosed NIDDM in Pundang Cha general hospital from December 1996 to June 1998 were enrolled (n=20). The 20 healthy volunteers comparable for age, sex, body surface area were enrolled as a control group. The echocardiography was performed in all patients before any treatment. Blood pressure, pulse rate, fasting and postprandial sugar and insulin level, serum total cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol were also checked in all patients.
RESULTS
There were no significant difference in blood pressure, pulse rate, total cholesterol, triglyceride, HDL-cholesterol and LDL-cholesterol level between both groups. E and A ratio of mitral inflow and peak diastolic velocity of pulmonary vein flow were significantly decreased in NIDDM group compared with control group (p<0.01). But there were no significant difference in left ventricular mass index, isovolumic relaxation time, deceleration time and peak atrial reversal velocity.
CONCLUSION
This study demonstrates that an impairment of left ventricular diastolic function occurs early in the NIDDM and investigation of diastolic function should be performed in the clinical evaluation of early diabetic patients.

Keyword

Diabetes mellitus; Non-insulin-dependent; Diastolic function; Echocardiography

MeSH Terms

Blood Pressure
Body Surface Area
Cholesterol
Deceleration
Diabetes Mellitus
Diabetes Mellitus, Type 2*
Echocardiography
Fasting
Healthy Volunteers
Heart Failure
Heart Rate
Hospitals, General
Humans
Hyperinsulinism
Hyperlipidemias
Insulin
Mortality, Premature
Pulmonary Veins
Relaxation
Triglycerides
Cholesterol
Insulin