RELATIONSHIP BETWEEN DIASTOLIC HYPERTENSION AND MYOCARDIAL MORPHOLOGYAND FUNCTION IN ELDERLY MALES WITH DIABETES-MELLITUS

The existence of a distinct diabetic cardiomyopathy, characterized by a raised left ventricular mass, has previously been suggested. However , as diabetes mellitus is associated with both left ventricular hypert rophy and hypertension a confounding effect of raised blood pressure i n diabetic patients has to be considered. In the present cross-section al study an echocardiographical examination was performed as part of a health screening survey in 582 males, aged 70 years. After the exclus ion of subjects with coronary heart disease or those on regular antihy pertensive treatment, 30 normotensive subjects with diabetes were comp ared with 10 subjects with non-insulin-dependent diabetes (NIDDM) and a diastolic blood pressure 90 mm Hg or more and 203 normotensive contr ol subjects with normal glucose tolerance. Both groups with NIDDM show ed a significantly increased left atrial diameter (4.4 +/- 0.7 vs 4.0 +/- 0.5 cm, p < 0.05) and an increased atrial component in diastole (A -wave, p < 0.01) compared to the control subjects. Left Ventricular ma ss was, however, only marginally and not significantly elevated in the diabetic subjects when compared to the healthy control subjects (133 +/- 19 and 133 +/- 28 vs 128 +/- 25 g/m(2)). Only in the subjects with concomitant diabetes and a raised blood pressure was the intraventric ular septum significantly enlarged (p < 0.05). Thus, in the present sa mple no distinct diabetic cardiomyopathy with an increased left ventri cular mass, independent of the influence of hypertension could be dete cted. The myocardial alterations in these diabetic males were restrict ed to an increased left atrial size and an impaired diastolic function .