title: Left ventricular function in normotensive young adults with well-controlled type 1 diabetes mellitus.
abstract: The aim of this study was to determine whether early myocardial structural and functional systolic and diastolic alterations in asymptomatic and uncomplicated patients with type 1 diabetes mellitus (DM) could be detected using the new highly sensitive echocardiographic techniques of integrated backscatter and color Doppler myocardial imaging. Forty asymptomatic and uncomplicated patients with type 1 DM and 40 gender- and age-matched normal controls were studied. All patients were analyzed by conventional and new echocardiographic techniques (integrated backscatter and color Doppler myocardial imaging). Patients with DM showed reduced systolic function compared with controls, evidenced by significantly lower peak strain, strain rates, and cyclic variation indexes at the septum (p <0.0001, <0.01, and <0.001, respectively) and at the posterior wall level (p <0.0001, <0.0001, and <0.001, respectively). On receiver-operating characteristic curve analysis, systolic strain and the cyclic variation index showed the highest discriminating power for separating patients with DM and control subjects. Neither structural or ultrastructural nor diastolic functional abnormalities were detected. On univariate regression analysis, a significant inverse correlation was found for DM duration with conventional (E/A ratio) and unconventional (tissue Doppler imaging E/A ratio) indexes of diastolic function, in the absence of any correlation for systolic function. In conclusion, highly sensitive ultrasonic techniques demonstrate evidence of left ventricular systolic dysfunction in the early stage of type 1 DM, in the absence of ultrastructural and left ventricular diastolic functional abnormalities.
authors.affiliation: Cardiac and Thoracic Department, University of Pisa, Pisa, Italy. a.dicori@virgilio.it
authors.forename: Andrea
authors.initials: A
authors.lastname: Di Cori
authors.forename: Vitantonio
authors.initials: V
authors.lastname: Di Bello
authors.forename: Roberto
authors.initials: R
authors.lastname: Miccoli
authors.forename: Enrica
authors.initials: E
authors.lastname: Talini
authors.forename: Caterina
authors.initials: C
authors.lastname: Palagi
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Delle Donne
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Penno
authors.forename: Carmela
authors.initials: C
authors.lastname: Nardi
authors.forename: Cristina
authors.initials: C
authors.lastname: Bianchi
authors.forename: Mario
authors.initials: M
authors.lastname: Mariani
authors.forename: Stefano
authors.initials: S
authors.lastname: Del Prato
authors.forename: Alberto
authors.initials: A
authors.lastname: Balbarini
mesh_terms: D000328:Adult; D001794:Blood Pressure; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1; D018618:Echocardiography, Doppler, Color; D005260:Female; D006801:Humans; D008297:Male; D012372:ROC Curve; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology*