Determination of left ventricular mass by echocardiography in normotensivediabetic patients

Patients with Type 2 diabetes mellitus (DM) have excessive cardiovascular m orbidity and mortality, even in the absence of hypertension. Left ventricul ar hypertrophy (LVH), which is an ominous prognostic sign and an independen t risk factor for cardiac events, is often present in Type 2 DM patients. F orty-two Type 2 DM patients without hypertension, all of whom had been diag nosed more than 10 years ago, were examined in the present study. They had no evidence of renal dysfunction and had not received any anti-hypertensive drugs. Age matched healthy normal subjects (n=47) were recruited as contro ls. All participants were classified according to the left ventricular mass index (LVMI) using M-mode echocardiography and their systolic function (fr actional shortening) was examined. The systolic function was not significan tly different between the Type 2 DM and control groups. LVH can be seen eve n in the normotensive Type 2 DM patients, with these patients still having a higher LVMI than the normal control subjects. Although the plasma insulin levels were not significantly increased in the Type 2 DM patients, the LVM I significantly correlated with plasma insulin levels. However, the LVMI di d not significantly correlate with plasma fasting glucose and hemoglobin Al c in the Type 2 DM patients. These results suggest that LVH in Type 2 DM pa tients without hypertension may be associated with elevated plasma insulin levels.