Morphological and functional parameters of the heart and vessels in patients with type 2 diabetes mellitus and cardiovascular autonomic neuropathy
https://doi.org/10.14341/DM2014241-46
Abstract
Objective.
To evaluate morphological and functional parameters of the heart and vessels in patients with type 2 diabetes mellitus (DM2) and diabetic cardiovascular autonomic neuropathy (CAN).
Materials and methods.
A total of 139 patients with DM2 and hypertension (mean age: 53.1?4.9 years; mean duration of hypertension: 9.7?7.8 years) were included in this study. Based on cardiovascular autonomic function test results (electrocardiography, heart rate variability) patients were divided into 2 groups as follows: Group 1 included 40 patients without CAN and Group 2 included 99 patients with CAN. The control group comprised 30 patients with hypertension and normal carbohydrate metabolism (mean age: 53.1?6.0 years; mean duration of hypertension: 10.9?8.5 years). All patients underwent ultrasonography of the heart and common carotid artery.
Results.
Group 2 patients showed a significant decrease in maximal transmitral flow velocity during early diastolic filling (0.61?0.12 m/s) and a decrease in maximal transmitral flow velocity during late diastolic filling (0.65?0.11 m/s) compared with Group 1 patients (0.66?0.09 m/s and 0.69?0.09 m/s, respectively, р <0.05) and control group patients (0.71?0.16 m/s and 0.69?0.14 m/s, respectively, р <0,05). Further, Group 2 patients showed a significant increase in left ventricular mass and ventricular end-diastolic volume (253.3?67.2 g and 120.6?25.2 ml, respectively) compared with control group patients (204.6?72.7 g and 110.4?22.2 ml, respectively, р <0.05) and a significant increase in intima-media complex thickness (IMT) (1.28?0.15 mm) compared with Group 1 patients (1.17?0.19 mm, р = 0.004).
Conclusion.
Increased left ventricular mass and heart volume parameters (end-systolic volume and end-diastolic volume), left ventricular diastolic dysfunction and increased common carotid artery diameter caused by increased IMT are the main determinants of CAN in patients with diabetes.
To evaluate morphological and functional parameters of the heart and vessels in patients with type 2 diabetes mellitus (DM2) and diabetic cardiovascular autonomic neuropathy (CAN).
Materials and methods.
A total of 139 patients with DM2 and hypertension (mean age: 53.1?4.9 years; mean duration of hypertension: 9.7?7.8 years) were included in this study. Based on cardiovascular autonomic function test results (electrocardiography, heart rate variability) patients were divided into 2 groups as follows: Group 1 included 40 patients without CAN and Group 2 included 99 patients with CAN. The control group comprised 30 patients with hypertension and normal carbohydrate metabolism (mean age: 53.1?6.0 years; mean duration of hypertension: 10.9?8.5 years). All patients underwent ultrasonography of the heart and common carotid artery.
Results.
Group 2 patients showed a significant decrease in maximal transmitral flow velocity during early diastolic filling (0.61?0.12 m/s) and a decrease in maximal transmitral flow velocity during late diastolic filling (0.65?0.11 m/s) compared with Group 1 patients (0.66?0.09 m/s and 0.69?0.09 m/s, respectively, р <0.05) and control group patients (0.71?0.16 m/s and 0.69?0.14 m/s, respectively, р <0,05). Further, Group 2 patients showed a significant increase in left ventricular mass and ventricular end-diastolic volume (253.3?67.2 g and 120.6?25.2 ml, respectively) compared with control group patients (204.6?72.7 g and 110.4?22.2 ml, respectively, р <0.05) and a significant increase in intima-media complex thickness (IMT) (1.28?0.15 mm) compared with Group 1 patients (1.17?0.19 mm, р = 0.004).
Conclusion.
Increased left ventricular mass and heart volume parameters (end-systolic volume and end-diastolic volume), left ventricular diastolic dysfunction and increased common carotid artery diameter caused by increased IMT are the main determinants of CAN in patients with diabetes.
Supporting agencies: Novosibirsk State Regional Hospital, Novosibirsk
About the Authors
Irina Arkad'evna Bondar'
Novosibirsk State Medical University, Novosibirsk
Russian Federation
MD, PhD, Professor, Head of the Endocrinology department in Novosibirsk State Medical University
Competing Interests:
Russian Federation
MD, PhD, Professor, Head of the Endocrinology department in Novosibirsk State Medical University
Competing Interests:
Авторы декларируют отсутствие двойственности (конфликта) интересов, связанных с рукописью.
Alexander Aristarkhovich Demin
Novosibirsk State Medical University, Novosibirsk
Russian Federation
MD, PhD, Professor, Head of the Internal Medicine and Clinical Pharmacology department of the Medical Faculty in Novosibirsk State Medical University
Competing Interests:
Russian Federation
MD, PhD, Professor, Head of the Internal Medicine and Clinical Pharmacology department of the Medical Faculty in Novosibirsk State Medical University
Competing Interests:
Авторы декларируют отсутствие двойственности (конфликта) интересов, связанных с рукописью.
Olesya Yur'evna Shabel'nikova
Novosibirsk State Regional Hospital, Novosibirsk
Russian Federation
MD, PhD, head of the Novosibirsk State Regional Hospital
Competing Interests:
Russian Federation
MD, PhD, head of the Novosibirsk State Regional Hospital
Competing Interests:
Авторы декларируют отсутствие двойственности (конфликта) интересов, связанных с рукописью.
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Bondar' I.A., Demin A.A., Shabel'nikova O.Yu. Morphological and functional parameters of the heart and vessels in patients with type 2 diabetes mellitus and cardiovascular autonomic neuropathy. Diabetes mellitus. 2014;17(2):41-46. https://doi.org/10.14341/DM2014241-46
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