Skip to main content
PMC home page
British Heart Journal logoLink to British Heart Journal
. 1981 Feb;45(2):122–128. doi: 10.1136/hrt.45.2.122

Left ventricular function in diabetes mellitus. I: Methodology, and prevalence and spectrum of abnormalities.

L M Shapiro, A P Howat, M M Calter
PMCID: PMC482499  PMID: 7006655

Abstract

Frequent abnormalities of left ventricular function were detected in 212 established diabetic patients using non-invasive techniques. Diabetics without angina or heart failure (n = 185) were significantly different from normal subjects (n = 50) in beat-to-beat variation, ratio of pre-ejection period to left ventricular ejection time, pre-ejection period index, isovolumic relaxation time, and interval from minimal dimension to mitral valve opening. Diabetics with angina (n = 18) were similar to control subjects with angina (n = 25); they showed a significant dimension change during the isovolumic period as compared with other diabetics and normals. Sixteen diabetics without angina also showed outward motion during the isovolumic period (incoordinate relaxation) and 13 had abnormal systolic time intervals. Four diabetics suffered a myocardial infarction during the study period; all had previously shown incoordination. Comparison of diabetics with a diastolic blood pressure below 100 mmHg and between 100 and 125 mmHg showed that the latter had a thicker posterior wall; the enlarged systolic dimension and reduced fractional shortening were the result of the inclusion of five of the 11 diabetic subjects with heart failure in the hypertensive group. Insulin-dependent diabetics tend to have more pronounced abnormalities of left ventricular function than those not requiring insulin. Patients selected from a diabetic clinic frequently have impaired left ventricular function, and ventricular hypertrophy, when present, in primarily caused by hypertension.

Full text

PDF

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ahmed S. S., Jaferi G. A., Narang R. M., Regan T. J. Preclinical abnormality of left ventricular function in diabetes mellitus. Am Heart J. 1975 Feb;89(2):153–158. doi: 10.1016/0002-8703(75)90039-3. [DOI] [PubMed] [Google Scholar]
  2. Barnes A. J., Locke P., Scudder P. R., Dormandy T. L., Dormandy J. A., Slack J. Is hyperviscosity a treatable component of diabetic microcirculatory disease? Lancet. 1977 Oct 15;2(8042):789–791. doi: 10.1016/s0140-6736(77)90724-3. [DOI] [PubMed] [Google Scholar]
  3. Chen W., Gibson D. Mechanisms of prolongation of pre-ejection period in patients with left ventricular disease. Br Heart J. 1979 Sep;42(3):304–310. doi: 10.1136/hrt.42.3.304. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Chen W., Gibson D. Relation of isovolumic relaxation to left ventricular wall movement in man. Br Heart J. 1979 Jul;42(1):51–56. doi: 10.1136/hrt.42.1.51. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Crall F. V., Jr, Roberts W. C. The extramural and intramural coronary arteries in juvenile diabetes mellitus: analysis of nine necropsy patients aged 19 to 38 years with onset of diabetes before age 15 years. Am J Med. 1978 Feb;64(2):221–230. doi: 10.1016/0002-9343(78)90049-9. [DOI] [PubMed] [Google Scholar]
  6. D'Elia J. A., Weinrauch L. A., Healy R. W., Libertino J. A., Bradley R. F., Leland O. S., Jr Myocardial dysfunction without coronary artery disease in diabetic renal failure. Am J Cardiol. 1979 Feb;43(2):193–199. doi: 10.1016/s0002-9149(79)80004-1. [DOI] [PubMed] [Google Scholar]
  7. Fischer V. W., Barner H. B., Leskiw M. L. Capillary basal laminar thichness in diabetic human myocardium. Diabetes. 1979 Aug;28(8):713–719. doi: 10.2337/diab.28.8.713. [DOI] [PubMed] [Google Scholar]
  8. Fuller J. H., Keen H., Jarrett R. J., Omer T., Meade T. W., Chakrabarti R., North W. R., Stirling Y. Haemostatic variables associated with diabetes and its complications. Br Med J. 1979 Oct 20;2(6196):964–966. doi: 10.1136/bmj.2.6196.964. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Hamby R. I., Zoneraich S., Sherman L. Diabetic cardiomyopathy. JAMA. 1974 Sep 23;229(13):1749–1754. [PubMed] [Google Scholar]
  10. Hilsted J., Jensen S. B. A simple test for autonomic neuropathy in juvenile diabetics. Acta Med Scand. 1979;205(5):385–387. doi: 10.1111/j.0954-6820.1979.tb06069.x. [DOI] [PubMed] [Google Scholar]
  11. Jarrett R. J., Keen H. Hyperglycaemia and diabetes mellitus. Lancet. 1976 Nov 6;2(7993):1009–1012. doi: 10.1016/s0140-6736(76)90844-8. [DOI] [PubMed] [Google Scholar]
  12. Kannel W. B., McGee D. L. Diabetes and cardiovascular disease. The Framingham study. JAMA. 1979 May 11;241(19):2035–2038. doi: 10.1001/jama.241.19.2035. [DOI] [PubMed] [Google Scholar]
  13. Ledet T. Diabetic cardiopathy. Quantitative histological studies of the heart from young juvenile diabetics. Acta Pathol Microbiol Scand A. 1976 Sep;84(5):421–428. [PubMed] [Google Scholar]
  14. McMillan D. E., Utterback N. G., La Puma J. Reduced erythrocyte deformability in diabetes. Diabetes. 1978 Sep;27(9):895–901. doi: 10.2337/diab.27.9.895. [DOI] [PubMed] [Google Scholar]
  15. Regan T. J., Lyons M. M., Ahmed S. S., Levinson G. E., Oldewurtel H. A., Ahmad M. R., Haider B. Evidence for cardiomyopathy in familial diabetes mellitus. J Clin Invest. 1977 Oct;60(4):884–899. doi: 10.1172/JCI108843. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Rubler S., Dlugash J., Yuceoglu Y. Z., Kumral T., Branwood A. W., Grishman A. New type of cardiomyopathy associated with diabetic glomerulosclerosis. Am J Cardiol. 1972 Nov 8;30(6):595–602. doi: 10.1016/0002-9149(72)90595-4. [DOI] [PubMed] [Google Scholar]
  17. Rubler S., Sajadi R. M., Araoye M. A., Holford F. D. Noninvasive estimation of myocardial performance in patients with diabetes. Effect of alcohol administration. Diabetes. 1978 Feb;27(2):127–134. doi: 10.2337/diab.27.2.127. [DOI] [PubMed] [Google Scholar]
  18. Sanderson J. E., Brown D. J., Rivellese A., Kohner E. Diabetic cardiomyopathy? An echocardiographic study of young diabetics. Br Med J. 1978 Feb 18;1(6110):404–407. doi: 10.1136/bmj.1.6110.404. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Seneviratne B. I. Diabetic cardiomyopathy: the preclinical phase. Br Med J. 1977 Jun 4;1(6074):1444–1446. doi: 10.1136/bmj.1.6074.1444. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Shapiro L. M., Leatherdale B. A., Coyne M. E., Fletcher R. F., Mackinnon J. Prospective study of heart disease in untreated maturity onset diabetics. Br Heart J. 1980 Sep;44(3):342–348. doi: 10.1136/hrt.44.3.342. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Upton M. T., Gibson D. G., Brown D. J. Echocardiographic assessment of abnormal left ventricular relaxation in man. Br Heart J. 1976 Oct;38(10):1001–1009. doi: 10.1136/hrt.38.10.1001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Weissler A. M., Harris W. S., Schoenfeld C. D. Systolic time intervals in heart failure in man. Circulation. 1968 Feb;37(2):149–159. doi: 10.1161/01.cir.37.2.149. [DOI] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES