No evidence for systolic or diastolic left ventricular dysfunction at restin selected patients with long-term Type I diabetes mellitus

We assessed left ventricular systolic and diastolic function using pulsed-w aved Doppler echocardiography in a selected group of 20 patients with insul in-dependent diabetes mellitus (IDDM) (mean age, 35 +/- 8 years; mean diabe tes duration, 17 +/- 7 years). Our patients were free of autonomic neuropat hy and major micro- or macrovascular complications and had no evidence of i schemic heart disease or hypertension. The results were compared with those of 20 age- and sex-matched control subjects. We found that left ventricula r geometry and mass, systolic function by M-mode and 2D-echocardiography, i sovolumetric relaxation time, deceleration time and the PEP/LVET ratio were not significantly different between patients and control subjects. Hemodyn amic parameters were also not significantly different except for a slightly higher heart rate in the patient group (75 +/- 11 vs. 68 +/- 6 bpm, P = 0. 019). After correction of A-peak velocities for differences in heart rate, there was no significant difference of Doppler indices of diastolic left ve ntricular function between patients and control subjects. The absence of si gnificant left ventricular systolic and diastolic dysfunction by Doppler ec hocardiography in our study patients may be explained by our patient select ion. Left ventricular dysfunction in diabetic patients without concomitant hypertensive or ischemic heart disease may only occur in conjunction with m icrovascular disease in other organ systems, with autonomic neuropathy or w ith poor metabolic control. (C) 1999 European Society of Cardiology. All ri ghts reserved.