The influence of glycemia on the left ventricular diastolic function in patients with arterial hypertension

Abstract

Arterial hypertension is a disease which has influence on the left ventricular diastolic function. It has been suggested that impairment of the left ventricular diastolic function in patients with diabetes mellitus is due to arterial hypertension and diffuse peripherial and coronary atherosclerosis which appear early in diabetic patients. Now, however, it is thought, that other mechanisms are responsable for the development of diabetic cardiomyopathy. The aim of the study was to investigate the effect of glycemia on the left ventricular diastolic function in patients with arterial hypertension. The study included 60 patients with arterial hypertension: 30 (50.00%) patients with diabetes mellitus and 30 (50.00%) without diabetes mellitus. The parameters of diastolic function were measured by the pulsed Doppler echocardiographic technique. Isovolumetric relaxation time, deceleration time, maximum velocity of the early stage of ventricular filling, maximum velocity of the late stage of ventricular filling and the early/late stage of ventricular filling ratio were used to assess the diastolic function. The patients with arterial hypertension and diabetes mellitus compared to the patients with arterial hypertension without diabetes mellitus were significantly obese (p < 0.001), had significantly higher glycemia (p < 0.0001) and left atrial volume (p < 0.05). The patients with arterial hypertension and diabetes mellitus compared to the patients with arterial hypertension without diabetes mellitus had significantlly: longer deceleration time (p < 0.05), lower velocity of early stage of ventricular filling (p < 0.05) and lower early/late stage of ventricular filling ratio (p < 0.01). Diastolic function parameters of patients with diabetes mellitus are significantly changed: deceleration time is longer, early stage of ventricular filling and early/late ventricular filling ratio are lower.