The influence of diabetic autonomous neuropathy on myocardial remodeling in type 1 diabetes mellitus
https://doi.org/10.14341/2072-0351-5634
Abstract
Aim.
To assess the influence of diabetic autonomous neuropathy (DAN) on left ventricular myocardial remodeling in type 1 diabetes mellitus.
Materials and methods.
The study included 78 patients (30 men and 48 women) with DM1 (mean age 28.9?8.3 years, DM1 duration9.7?7.5 years). DAN was diagnosed by standard ECG tests (Valsalva and breathing tests). The patients were examined using echocardiographywith the measurement of the thickness of interventricular septum (IVS) and left ventricle posterior wall (PW), end diastolic and systolic size (EDS and ESS) of the left ventricle, left ventricular myocardial mass (MM), MM index and relative wall thickness (RWT). LV hypertrophy(LVH) was diagnosed at MM index ?134 g/m2 in men and ?110 g/m2 in women; concentric and excentric types of LV hypertrophy wererecorded at RWT ?0.45 and <0.45 respectively.
Results.
The patients were divided into 3 groups depending on severity of DAN: well-apparent DAN (n=18), early DAN manifestations (n=40),absence of DAN (n=20). IVS thickness and RWT in group 1 were greater than in other groups. LVH occurred in 5.9, 15, and 43.8% of the patientsrespectively (?2=7.8, p=0.02). The frequency of concentric and excentric LVH did not differ. Patients with LVH showed higher values of OSBP andODBP, pulse rate, and parameters of lipid metabolism. Multifactor analysis showed that LPW and IVS thickness more frequently increased in menin proportion to age, heart rate, changes in the Valsalva index (R2=0.55, p<0.05). MM index depended on age, sex, pulse rate, and proteinurea(R2=0.59, p<0.05) while RWT depended on the heart rate and Valsalva index (R2=0.47, p<0.05).
Conclusion.
A rise in the heart rate and decrease of Valsalva index in DM1 patients with progressive cardiovascular form of DAN lead to LVH.
To assess the influence of diabetic autonomous neuropathy (DAN) on left ventricular myocardial remodeling in type 1 diabetes mellitus.
Materials and methods.
The study included 78 patients (30 men and 48 women) with DM1 (mean age 28.9?8.3 years, DM1 duration9.7?7.5 years). DAN was diagnosed by standard ECG tests (Valsalva and breathing tests). The patients were examined using echocardiographywith the measurement of the thickness of interventricular septum (IVS) and left ventricle posterior wall (PW), end diastolic and systolic size (EDS and ESS) of the left ventricle, left ventricular myocardial mass (MM), MM index and relative wall thickness (RWT). LV hypertrophy(LVH) was diagnosed at MM index ?134 g/m2 in men and ?110 g/m2 in women; concentric and excentric types of LV hypertrophy wererecorded at RWT ?0.45 and <0.45 respectively.
Results.
The patients were divided into 3 groups depending on severity of DAN: well-apparent DAN (n=18), early DAN manifestations (n=40),absence of DAN (n=20). IVS thickness and RWT in group 1 were greater than in other groups. LVH occurred in 5.9, 15, and 43.8% of the patientsrespectively (?2=7.8, p=0.02). The frequency of concentric and excentric LVH did not differ. Patients with LVH showed higher values of OSBP andODBP, pulse rate, and parameters of lipid metabolism. Multifactor analysis showed that LPW and IVS thickness more frequently increased in menin proportion to age, heart rate, changes in the Valsalva index (R2=0.55, p<0.05). MM index depended on age, sex, pulse rate, and proteinurea(R2=0.59, p<0.05) while RWT depended on the heart rate and Valsalva index (R2=0.47, p<0.05).
Conclusion.
A rise in the heart rate and decrease of Valsalva index in DM1 patients with progressive cardiovascular form of DAN lead to LVH.
About the Authors
Irina Arkad'evna Bondar'
Novosibirsk State Medical University, Novosibirsk
Elena Anatol'evna Koroleva
Novosibirsk State Medical University, Novosibirsk
Olga Grigor'evna Chudinova
Novosibirsk Regional Clinical Hospital,Novosibirsk
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Review
For citations:
Bondar' I.A., Koroleva E.A., Chudinova O.G. The influence of diabetic autonomous neuropathy on myocardial remodeling in type 1 diabetes mellitus. Diabetes mellitus. 2011;14(2):49-52. (In Russ.) https://doi.org/10.14341/2072-0351-5634
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