LEFT-VENTRICULAR FUNCTION IN INSULIN-DEPENDENT AND IN NON-INSULIN-DEPENDENT DIABETIC-PATIENTS - RADIONUCLIDE ASSESSMENT

The aim of this study was to compare, by gated radionuclide angiograph y, systolic and diastolic ventricular function in insulin-dependent (I DDM) and non-insulin-dependent (NIDDM) diabetic patients without overt cardiovascular disease. The study population consisted of 20 IDDM pat ients (15 male, 5 female; 40.7 +/- 10.3 years), 14 NIDDM patients (9 m ale, 5 female; 47.0 +/- 7.5 years) and 12 healthy subjects (7 male, 5 female; 41.5 +/- 6.3 years) as a control (C) group. The duration of di abetes (DD) and glycosylated hemoglobin (HbA(1C)) levels were signific antly higher in the IDDM patients. The ventricular ejection fraction a nd peak ejection rate (PER) were assessed by gated radionuclide left v entriculography and were similar in three groups, while the peak filli ng rate (PFR) was lower in the NIDDM patients compared to the IDDM pat ients (p < 0.05) and controlled healthy subjects (p < 0.01, IDDM = 3.3 9 +/- 1.14; NIDDM = 2.65 +/- 0.83; C = 3.55 +/- 0.73), the time to PFR was significantly more prolonged in the NIDDM group than in the IDDM (p < 0.05) and C groups (p < 0.05, NIDDM = 162 +/- 26; IDDM = 140 +/- 28; C = 142 +/- 23). The PFR/PER ratio was near the normal value (simi lar or equal to 1) in the IDDM patients and controlled subjects, while in the NIDDM patients it was reduced (similar or equal to=0.84 +/- 0. 18). Seven IDDM and 4 NIDDM patients had borderline signs of cardiovas cular autonomic neuropathy, unrelated to DD, HbA(1C) and scintigraphic parameters. Left ventricular systolic performance was substantially n ormal and similar in both the IDDM and NIDDM patients. Ventricular dia stolic filling was impaired in the NIDDM patients, as shown by the dec rease in PFR and in particular in the PFR/PER ratio. Our radionuclide data suggest that the NIDDM patients had a prevalent abnormality of ve ntricular diastolic performance, with respect to the IDDM patients, al though the latter patients had higher DD and HbA(1C) values.