Echocardiographic-determined left ventricular wall characteristics in insulin-dependent diabetic patients.

Abstract

Left ventricular wall mass, thickness and movement were investigated by echocardiography in 80 insulin-dependent diabetic patients with no signs of ischaemic heart disease and in 40 healthy controls. In diabetics with a disease duration of greater than 30 yr, urinary albumin excretion rate greater than 200 micrograms/min (clinical nephropathy), proliferative retinopathy or autonomic neuropathy, both the posterior wall thickness and the septal thickness were increased compared to controls. The posterior wall thickness and the septal thickness were positively correlated to blood pressure (p less than 0.001), disease duration (p less than 0.001), urinary albumin excretion rate (p less than 0.001), and negatively correlated to the heart variation during deep respiration (p less than 0.01). The left ventricular wall mass was correlated to both blood pressure (p less than 0.01) and urinary albumin excretion rate (p less than 0.01). By multiple regression analysis urinary albumin excretion rate, disease duration and heart rate variation during deep respiration did not add significantly to the correlation between left ventricular wall mass/wall thickness and blood pressure. The septal movement was reduced in diabetics with proliferative retinopathy or clinical nephropathy. In conclusion, left ventricular wall thickness and wall mass were closely related to blood pressure in insulin-dependent diabetics. Signs of impaired cardiac function, such as reduced septal movement, were seen only in patients with severe microvascular disease.