[Diabetic cardiomyopathy in mild diabetics: evaluation by thallium-201 scintigraphy and exercise radionuclide ventriculography].
Forty mildly diabetic men, with a mean age of 49 +/- 9.7 years, and without clinical or exercise electrocardiographic evidence of ischemic cardiac disease, participated in a study consisting of exercise thallium-201 myocardial scintigraphy and exercise radionuclide ventriculography. 1. Among the 40 patients, 16 (40%) showed no filling defect (negative cases). Mild defects (mild cases) and moderate defects (moderate cases) were observed in 12 and 12 cases, respectively. 2. The percent washout ratio was decreased in none of the 16 negative cases, in three of the 12 mild cases, and in 11 of the 12 moderate cases. 3. There were no significant statistical differences in age, duration of diabetes, fasting blood sugar, HbA1c, serum cholesterol, smoking or blood pressure. Percent of ideal body weight was greater in moderate cases (121 +/- 15%) compared to negative or mild cases (103 +/- 9%, 108 +/- 9%) (p less than 0.01). 4. The percent fractional shortening was decreased in mild cases and in moderate cases (34.6 +/- 6.3%, 32.6 +/- 8.4%) compared to negative cases (41.7 +/- 4.9%) (p less than 0.01). Weissler's index (PEP/ET) was higher in moderate cases (0.42 +/- 0.09) compared to negative or mild cases (0.35 +/- 0.05, 0.36 +/- 0.06) (p less than 0.05). 5. Left ventricular wall motion was abnormal on echocardiography in none of the 16 negative cases, in three of the 12 mild cases and in seven of the moderate cases. The site of echocardiographically abnormal wall motion coincided with the defect area on myocardial scintigraphy in six cases, but not in four cases. 6. Radionuclide ventriculographic studies statistically showed no significant differences in ejection fraction (EF), 1/3EF, time to peak ejection (TPE), ejection time (ET), peak ejection rate (PER), 1/3 filling fraction (FF), 1/3 peak filling rate (PFR) and time to peak filling (TPF). The peak filling rate (PFR) at rest was significantly lower in mild cases (2.4 +/- 0.5 EDV/sec, p less than 0.025). Although the PFR at rest in moderate cases was lower than in negative cases (2.9 +/- 0.6 EDV/sec, 3.2 +/- 0.7 EDV/sec), no significant difference was shown between them. The rate of increase in cardiac output was significantly lower in moderate cases compared to mild cases and negative cases (59 +/- 28%, 96 +/- 49%, 97 +/- 31%, p less than 0.05).(ABSTRACT TRUNCATED AT 400 WORDS)
Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo.
K
K
Amano
T
T
Sakamoto
J
J
Oku
K
K
Fujinami
T
T
Sugimoto
D000328:Adult; D009202:Cardiomyopathies / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D048909:Diabetes Complications; D004452:Echocardiography; D006321:Heart / Q000000981:diagnostic imaging*; D006352:Heart Ventricles; D006801:Humans; D008875:Middle Aged; D009200:Myocardial Contraction; D005082:Physical Exertion; D011877:Radionuclide Imaging; D013794:Thallium Radioisotopes
D013794:Thallium Radioisotopes