PRESERVED LEFT-VENTRICULAR SYSTOLIC AND DIASTOLIC FUNCTION IN NORMOALBUMINURIC INSULIN-DEPENDENT DIABETIC-PATIENTS WITH GLOMERULAR HYPERFILTRATION

This study was conducted to test the hypothesis that normotensive, nor moalbuminuric IDDM patients with gromerular hyperfiltration may presen t functional or structural cardiac abnormalities. Eleven normoalbuminu ric and normotensive IDDM patients with normal glomerular filtration r ate and 11 patients with hyperfiltration were compared with a group of 17 age and sex matched controls. Glomerular filtration rate was measu red by the Cr-51-EDTA technique and hyperfiltration was defined as a g lomerular filtration rate higher than 134 ml/min/1.73 m(2). Phonocardi ogram, M-mode and pulsed Doppler two-dimensional echocardiograms were performed to evaluate resting left ventricular dimensions, systolic an d diastolic function. Left ventricular dimensions, fractional shorteni ng, mean velocity of fiber shortening, early and late diastolic peak f illing velocity, deceleration time, mitral flow velocity integral, and isovolumic relaxation time were similar (ANOVA P > 0.05) in normal co ntrols, diabetic patients with normal glomerular filtration rate, and diabetic patients with hyperfiltration. In conclusion, the results of our controlled observations indicate that normoalbuminuric and normote nsive IDDM patients who have normal glomerular filtration rate or hype rfiltration have no Doppler-echocardiographic evidence of functional a nd structural abnormalities.