RESIDUAL LEFT-VENTRICULAR PUMP FUNCTION FOLLOWING ACUTE MYOCARDIAL-INFARCTION IN POSTMENOPAUSAL DIABETIC WOMEN

Background: The Framingham Study indicated that women with diabetes me llitus developed cardiac failure four times more often than those with out diabetes mellitus after acute myocardial infarction. However, ther e is little information on residual left ventricular pump function aft er myocardial infarction in female diabetic patients. Methods: To eval uate the difference between postmenopausal women and age-matched men i n the impact of diabetes mellitus on left ventricular pump function du ring the first year after myocardial infarction, radionuclide angiogra phy was performed during the third week after acute myocardial infarct ion and again 1 year later in 50 patients (21 women, 29 men) with diab etes mellitus and 62 patients (25 women, 37 men) without diabetes mell itus. Results: Although the radionuclide angiographic indices did not change during the first year after myocardial infarction in non-diabet ic patients, left ventricular end-diastolic volume increased, and the left ventricular ejection fraction, the regional ejection fraction of the non-infarcted area, and the ratio of arterial systolic blood press ure to left ventricular end-systolic volume (pressure:volume ratio) de creased in the diabetic patients. Furthermore, the degree of change in the left ventricular end-diastolic volume, the left ventricular eject ion fraction, the regional ejection fraction of the non-infarcted area , and the pressure:volume ratio in diabetic women was larger than that in diabetic men. Conclusion: The increase in the left ventricular end -diastolic volume and the decrease in the regional ejection fraction o f the non-infarcted area during the first year after myocardial infarc tion in postmenopausal women with diabetes mellitus indicate that fema le sex associated with diabetes mellitus may be important factors in l eft ventricular remodeling in postmenopausal women.