DIASTOLIC DYSFUNCTION IN YOUNG-PATIENTS WITH INSULIN-DEPENDENT DIABETES-MELLITUS AS DETERMINED BY AUTOMATED BORDER DETECTION

Diastolic dysfunction is an early harbinger for systolic dysfunction i n insulin-dependent diabetes mellitus (IDDM). To determine the role of automated border detection (ABD) in detecting diastolic abnormalities and whether IDDM control correlates with abnormalities, 21 young IDDM patients (22 +/- 4 years old) and 19 control subjects underwent echoc ardiography. ABD indices included the percent contribution to total le ft ventricular filling of the three phases of diastole (rapid filling, diastasis, and atrial contraction) and peak filling rate. Doppler ind ices included E/A ratio and peak filling rate. Rapid filling phase was lower in the IDDM patients compared with control subjects (73% +/- 5% versus 80% +/- 5%, p = 0.0006), and atrial contraction filling was hi gher (19% +/- 4% versus 14% +/- 3%, p = 0.0003). Doppler indexes showe d similar changes. Glycosylated hemoglobin, insulin dosage, and durati on of IDDM since puberty were associated with filling abnormalities. Y oung patients with IDDM have increased atrial contraction and reduced rapid filling phases detected by automatic border detection, and these diastolic abnormalities are related to the diabetic disease process.