ULTRASONIC VIDEODENSITOMETRIC ANALYSIS IN TYPE-1 DIABETIC MYOCARDIUM

Objective To test the hypothesis that quantitative analysis of two-dim ensional echocardiographic gray-level distributions could allow one to detect the early changes in acoustic properties of human diabetes myo cardium differentiating it from normal myocardium. Methods We evaluate d, by two-dimensional echocardiography, 28 asymptomatic type 1 insulin -dependent diabetic patients with normal ventricular function (group A ) and 15 age- and sex-matched healthy controls (group B). By selection , all of the diabetics were normotensive and had a negative maximal ex ercise stress, Echocardiographic images were digitized by using a cali brated digitization system, Quantitative texture analysis was accompli shed on data from the septum and posterior wall both at end-diastole a nd at end-systole, The following parameters were obtained: the mean gr ay level of the regions of interest, and its absolute SD, skewness, ku rtosis, and cyclic variation index. Results The main result of this st udy was that the cyclic variation indices of the echo amplitudes of th e septum and posterior wall in the diabetic group were significantly l ower than those in controls (P < 0.001 and P < 0.002, respectively), F urthermore, the diabetic group had a significantly higher mean gray le vel of the septum [group A 54.3 +/- 22.5 (mean +/- SD) versus group B 39.7 +/- 9.8, P < 0.03] at end-diastole, The mean gray-level of the po sterior wall was similar in the two groups, both at end-diastole and a t end-systole. Conclusion Alterations of cyclic echo amplitude (possib ly related to collagen deposition) can be detected in asymptomatic dia betic patients with normal resting function. Theoretically, this findi ng might be considered an early preclinical alteration, potentially re lated to subsequent development of 'diabetic cardiomyopathy'.