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Left ventricular dysfunction in normotensive Type 1 diabetic patients: the impact of autonomic neuropathy
Author(s) -
Taskiran M.,
Rasmussen V.,
Rasmussen B.,
FritzHansen T.,
Larsson H. B. W.,
Jensen G. B.,
Hilsted J.
Publication year - 2004
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2004.01145.x
Subject(s) - medicine , cardiology , diastole , left ventricular hypertrophy , doppler echocardiography , muscle hypertrophy , diabetes mellitus , magnetic resonance imaging , type 2 diabetes , endocrinology , blood pressure , radiology
Aims The pathophysiological mechanisms responsible for increased cardiovascular mortality in diabetic autonomic neuropathy (AN) are largely unknown. The aim was to determine the relative role of AN in the pathogenesis of cardiac diastolic dysfunction and left ventricular hypertrophy in Type 1 diabetes. Methods Ten Type 1 diabetic patients with AN, defined by cardiovascular tests (AN+) and 10 age‐ and sex‐matched patients without neuropathy (AN–) as well as 10 healthy subjects (C) participated in the study. Left ventricular diastolic function was assessed by Doppler echocardiography, whilst systolic function was evaluated by cine magnetic resonance (MR) imaging. Results Doppler echocardiography showed a significant decrease in E/A ratio, i.e. the ratio between peak E arly transmitral filling velocity during early diastole (E‐wave) and peak transmitral A trial filling velocity during late diastole (A‐wave), in AN+ compared with C ( P < 0.01) [0.95 ± 0.08 (mean ± sem ) (AN+); 1.19 ± 0.09 (AN–); 1.33 ± 0.10 (C)]. The E‐wave deceleration time was significantly shorter in AN+ compared with AN– and C ( P < 0.02) [178 ± 7 ms (AN+); 203 ± 9 ms (AN–); 205 ± 9 ms (C)]. Cine MR imaging showed a significantly greater left ventricular mass index in AN+ compared with C [103 ± 4 g/m 2 (AN+) vs. 98 ± 7 (AN–) and 92 ± 4 g/m 2 (C), P < 0.05]. Conclusion Autonomic neuropathy is associated with left ventricular hypertrophy and diastolic dysfunction in Type 1 diabetic patients.