Cardiac Dysfunction In Diabetes Research Articles

Protective effects of propionyl-L-carnitine on cardiac dysfunction in diabetes

Protective effects of propionyl-L-carnitine on cardiac dysfunction in diabetes

Radionuclide assessment of left ventricular function in patients with mycardial infarction and diabetes mellitus

The aim of this study was to compare left ventricular function, assessed by radionuclide angiocardiography, in 54 diabetics and 194 non-diabetics with acute myocardial infarction (AMI). The most meaningful results concern the inferior AMI group, whose left ventricular ejection fraction (LVEF) and regional wall motion were significantly lower in diabetics than in non-diabetics (LVEF was 44.2 +/- 11 vs. 51.6 +/- 9%, P less than 0.005; the regional wall motion score was 0.46 +/- 1 vs. 1.56 +/- 1, P less than 0.01, respectively), while no significant difference was observed in the anterior AMI group. However, in the group as a whole, the LVEF was 41 +/- 13% in diabetics and 47 +/- 13% in non-diabetics (P less than 0.01), the number of abnormally contracting segments was 2.0 +/- 0.9 and 1.5 +/- 1, respectively, and the wall motion score was 0.2 +/- 1.1 and 1.0 +/- 1.4, respectively (P less than 0.01). These data could be explained by an underlying cardiac dysfunction in diabetes, in addition to AMI. The more marked difference between diabetics and non-diabetics in inferior AMI might be related to the smaller infarct size in this group.

Cardiac function during stress testing in long-standing insulin-dependent diabetics.

Four dynamic tests of cardiac function were compared in a group of 13 long-standing insulin-dependent diabetics who had no clinical evidence of cardio-respiratory disease. One patient developed abnormal features during 24 hour ambulatory electrocardiograms while all 13 patients had normal exercise electrocardiograms. The change in left ventricular ejection fraction during dynamic supine exercise as measured by gated blood-pool scintigraphy was not significantly different from control subjects (p less than 0.1) while during cold stimulation testing the change in left ventricular ejection fraction in the diabetics was highly significantly different from the control subjects (p less than 0.01). Five of the patients had one or more abnormal tests of autonomic function. The cold stimulation test may be a sensitive index of cardiac dysfunction in diabetics but as the mechanism is unclear alternative explanations are possible. While the etiology of heart disease in such patients is uncertain it is likely to be multifactorial and this test may prove useful in investigating the natural history and pathogenesis of cardiac disease in diabetics.