Increased left atrial size relative to left ventricular size in young women with insulin-dependent diabetes; a pre-clinical sign of the specific heart disease of diabetes?
Echocardiography was performed on 71 young (mean age 26 years) insulin-dependent diabetic women without clinical evidence of heart disease and on 36 healthy women of the same age. 39 diabetic women had microvascular complications and 9 of them also had abnormalities in autonomic function tests. The diabetic women had smaller left ventricular (LV) end-diastolic diameters (44 vs. 47 mm, p less than 0.001) than the controls, although the left atrial sizes did not differ between the groups. They also had higher heart rates (80 vs. 70 bpm, p less than 0.001) and shortening fractions (35 vs. 33%, p less than 0.01), smaller stroke volumes (66 vs. 76 ml, p less than 0.01) and thicker interventricular septae (9 vs. 8 mm, p less than 0.01) than the controls. The diminution of LV size was most prominent in patients with severe microvascular complications. These data suggest that the myocardial contractility of young insulin-dependent diabetic women is not depressed, but rather exaggerated. The observed diminution of LV size in combination with normal left atrial diameter may reflect increased LV wall stiffness, a possible pre-clinical manifestation of the specific heart disease of diabetes.
Department of Medicine, Oulu University Central Hospital, Finland.
K E
KE
Airaksinen
M J
MJ
Ikäheimo
M K
MK
Linnaluoto
H V
HV
Huikuri
J T
JT
Takkunen
D000293:Adolescent; D000328:Adult; D002312:Cardiomyopathy, Hypertrophic / Q000473:pathology*; D003327:Coronary Disease / Q000473:pathology; D003922:Diabetes Mellitus, Type 1 / Q000473:pathology*; D003925:Diabetic Angiopathies / Q000473:pathology; D004452:Echocardiography; D005260:Female; D006325:Heart Atria / Q000473:pathology*; D006346:Heart Septum / Q000473:pathology; D006352:Heart Ventricles / Q000473:pathology*; D006439:Hemodynamics; D006801:Humans