LEFT-VENTRICULAR DIASTOLIC FILLING IN DIABETES-MELLITUS WITH AND WITHOUT HYPERTENSION

Left ventricular diastolic filling by Doppler echocardiography was inv estigated in 84 diabetic patients without evidence of heart disease an d in 84 normotensive nondiabetic age- and sex-matched control subjects . Diabetic patients were subdivided into two groups on the basis of th e presence of arterial hypertension. Group 1 comprised 41 normotensive diabetic patients (19 men, 22 women, mean age 63.7 +/- 9.1 years); Gr oup 2 comprised 43 hypertensive diabetics (15 men, 28 women, mean age 65.6 +/- 9.6 years). Doppler measures of diastolic filling were signif icantly altered in the two groups as compared with control subjects. P eak atrial flow velocity, velocity integral for the atrial filling per iod, and atrial filling fraction were increased, whereas the ratio of peak early to peak atrial flow velocity and the ratio of flow velocity integrals were decreased, especially in Group 2 patients. Thirteen pa tients in Group 1 (32%) and 17 in Group 2 (40%) had evidence of diasto lic dysfunction, as assessed by the presence of at least two independe nt abnormal indices (outside age-corrected 95% confidence interval). I n each group, patients with altered diastolic filling differed slightl y from diabetic patients with normal Doppler indices, tending to incre ased wall thickness and left ventricular mass. In conclusion, diastoli c filling of the left ventricle is frequently altered in diabetic pati ents and is adversely affected by arterial hypertension whose coexiste nce further impairs left ventricular relaxation.