Copyright © 2005, The European Society of Cardiology
Impaired myocardial function in newly onset Type 2 diabetes associates with arterial stiffness*
aClinical Physiology and Nuclear Medicine, Seinäjoki Central Hospital, Hanneksenrinne 7, 60220 Seinäjoki, Finland
bDepartment of Medicine, Central Hospital of Kymenlaakso, Kotka, Finland
cAppleton Heart Institute, Appleton, Wisconsin, USA
dReumasäätiön sairaala, Heinola, Finland
Received 4 March 2005; received in revised form 22 June 2005; accepted after revision 7 July 2005.
* Corresponding author. Tel.: +358 6 415 4586; fax: +358 6 415 4994. seanlo{at}uta.fi antti.loimaala{at}epshp.fi
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Abstract |
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Aim The aim of this study was to evaluate myocardial function using pulsed and color-coded tissue Doppler imaging (TDI) and vascular wall elasticity using whole-body impedance cardiography (ICG) in patients with newly diagnosed Type 2 diabetes mellitus (DM2), and to compare the measurements with those of healthy controls.
Methods Systolic (SBP) and diastolic (DBP) blood pressure and glycocylated hemoglobin (HbA1c) were measured in 49 men (mean age 52.3±5.6 years, duration of DM2 1.8 years), and 15 healthy male control subjects (48.3±7.4 years). Mitral annular peak systolic (Svm), early (Evm), and late (Avm) diastolic velocities as well as myocardial peak systolic (Sv), early (Ev) and late diastolic (Av) velocity from middle segments of the anterior, inferior and lateral wall and the inferior septum were measured by TDI. ICG at rest was used to measure cardiac index (CI) and pulse wave velocity (PWV).
Results The patients had higher body mass index (BMI 29.1±3.7 vs. 25.2±2.4kg/m2, p=0.000) and SBP (142±15 vs. 120±7mmHg, p=0.005) than the controls, CI was comparable (2.8±0.5 vs. 2.8±0.6l/min/m2). The patients had lower age adjusted myocardial Sv (3.8±1.1 vs. 4.8±1.1cm/s, p=0.002) and Ev (4.6±1.6 vs. 6.2±1.7cm/s, p=0.011), and also mitral annulus peak early diastolic velocity (Evm 7.8±1.9 vs. 10.4±2.6cm/s, p=0.001). In diabetic patients PWV (14.2±2.7 vs. 10.0±1.7m/s, p=0.002) was higher. Age (r=–0.39, p=0.001), BMI (r=–0.44, p=0.000) and PWV (r=–0.52, p=0.000) correlated significantly with Evm. PWV correlated with age (r=0.50, p=0.000), SBP (r=0.67, p=0.000), and HBA1c (r=0.36, p=0.010). In stepwise regression analysis, PWV (β=–0.39, p=0.000) was the major determinant of Evm.
Conclusion Myocardial function is impaired in asymptomatic patients with newly detected DM2 consistent with diabetic heart muscle disease. Arterial stiffness is strongly related to myocardial dynamics, and both may have the same pathophysiologic background.
Keywords: Diabetes; Tissue Doppler imaging; Pulse wave velocity
* Part of this study was presented at the XXII Congress of The European Society of Cardiology, August 26–30th 2000, Amsterdam, Netherlands.
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