SILENT-MYOCARDIAL-ISCHEMIA IN PATIENTS WI TH DIABETES-MELLITUS WITHOUT CLINICAL SIGNS OF CORONARY HEART-DISEASE

A total of 40 patients with diabetes mellitus without anginal episodes and equivalents were studied. 24-hour monitoring identified 2 groups of patients: (1) 13 patients with recorded silent myocardial ischemic episodes and (2) 23 patients without episodes. Four patients were foun d to have stress-echocardiograpgic silent myocardial ischemia. Silent myocardial ischemia was detected in 42.5 % of patients with diabetes m ellitus. The patients from Group 1 exhibited more frequently Type II d iabetes mellitus whose duration was over 9 years and concurrent retino - and polyneuropathies. There was a relationship between silent myocar dial ischemia to heart failure and myocardial hypertrophy as evidenced by two-dimensional echocardiography. The patients from Group 1 had a higher pain sensitivity threshold than those from Group 2. Autonomic p olyneuropathy was observed in 46 % of Group 1 patients and in 21 % of Group 2 patients.