Cardiomyopathy in childhood diabetes mellitus: incidence, time of onset, and relation to metabolic control

Hausdorf, G.; Rieger, Ulrich M.; Koepp, P

doi:10.1016/0167-5273(88)90083-6

Cited by 31 publications

(12 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This pattern has also been reported by other authors [9,11]. Hausdorf et al [8] found the fractional shortening normal in a group of children with diabetes compared with a group of nondiabetic children; however, there was an inverse correlation between glycated hemoglobin and fractional shortening within the diabetic group.…”

Section: Discussionsupporting

confidence: 79%

Echocardiographic load-independent indices of contractility in children and adolescents with type I diabetes: Effect of metabolic control and insulin on left ventricular performance

Schwingshandl¹,

Ward²,

Silink³

et al. 1995

Pediatr Cardiol

View full text Add to dashboard Cite

A case-control study was carried out in a tertiary referral teaching hospital to evaluate left ventricular contractility in children and adolescents with type 1 diabetes and to study factors influencing left ventricular contractility. Thirty-four children and young adults with type 1 diabetes (age 10.8-21.8 years) were randomly selected from approximately 400 patients of the same age range in the outpatient department and compared with 16 non-diabetic controls (age 7.3-21.2 years). The relation of end-systolic wall stress to velocity of circumferential fiber shortening as a standard deviation score (SDS) from the normal range described by Colan et al. was used to assess left ventricular contractility. In the diabetic group the effect of age, duration of diabetes, metabolic control, insulin dose, and autonomic function on left ventricular contractility were studied. It was found that the end-systolic wall stress-velocity of circumferential fiber shortening relation was not different between diabetic subjects and controls [+0.52 (SEM 0.21) vs +0.90 (SEM 0.26) SDS, p = 0.3]. In the diabetic subjects, the end-systolic wall stress-velocity of circumferential fiber shortening relation was positively correlated with glycated hemoglobin (r = 0.37, p = 0.03) and insulin dose per kilogram of body weight (r = 0.36, p = 0.04). Those two variables together explained 24% of the variability in the end-systolic wall stress-velocity of circumferential fiber shortening relation. Twenty-eight of the diabetic subjects were also assessed for cardiac autonomic function. Disturbances of cardiac autonomic function were not associated with increased contractility.(ABSTRACT TRUNCATED AT 250 WORDS)

show abstract

Section: Discussionsupporting

confidence: 79%

Echocardiographic load-independent indices of contractility in children and adolescents with type I diabetes: Effect of metabolic control and insulin on left ventricular performance

Schwingshandl¹,

Ward²,

Silink³

et al. 1995

Pediatr Cardiol

View full text Add to dashboard Cite

show abstract

“…However, the existence of a primary myocardial disease in diabetic patients, “diabetic cardiomyopathy”, has been proposed (1-9). The existence of diabetic cardiomyopathy was first proposed by Rubler et al in 1972 on the basis of postmortem findings (10,11). Subsequently, abnormalities in both systolic and diastolic performance in diabetic subjects have been demonstrated in animal and human studies.…”

Section: Introductionmentioning

confidence: 99%

The Development of Heart Failure in Patients With Diabetes Mellitus and Pre-Clinical Diastolic Dysfunction

From

Scott

Chen

2010

Journal of the American College of Cardiology

412

270

View full text Add to dashboard Cite

Objectives Evaluate the outcomes of preclinical diastolic dysfunction in diabetic patients Background Studies have reported a high prevalence of preclinical diastolic dysfunction among patients with diabetes mellitus. Methods We identified all diabetic patients with a tissue Doppler assessment of diastolic function in Olmsted County, MN from 2001 to 2007. Diastolic dysfunction was defined as a Doppler mitral E/e′ ratio >15. The main outcome was the development of heart failure (HF). Secondary outcomes were the development of atrial fibrillation and death. Results Overall, 1,760 diabetic patients with a tissue Doppler echocardiographic assessment of diastolic function were identified; 411 patients (23%) had diastolic dysfunction. Using multivariable Cox's proportional hazard modeling, we determined that for every 1 unit increase in the mitral E/e′ ratio, the hazard of HF increased by 3% (HR=1.03, 95% CI=1.01-1.06; p=0.006) and that diastolic dysfunction was associated with the subsequent development of HF after adjustment for age, sex, body mass index, hypertension, coronary disease and echocardiographic parameters (HR=1.61, 95% CI=1.17-2.20; p=0.003). The cumulative probability of the development of HF at 5 years for diabetic patients with diastolic dysfunction was 36.9% compared to 16.8% for patients without diastolic dysfunction (P<0.001). Furthermore, diabetic patients with diastolic dysfunction had a significantly higher mortality compared to those without diastolic dysfunction. Conclusion We demonstrated that an increase in the E/e′ ratio in diabetic patients is associated with the subsequent development of HF and increased mortality independent of hypertension, coronary disease or other echocardiographic parameters.

show abstract

“…Numerous studies have reported normal LV systolic function at rest in most type 1 diabetic patients (4), whereas others have suggested increased LV systolic function (5,6). Several investigators have shown abnormal LV diastolic function in the majority of type 1 diabetic patients (7)(8)(9)(10)(11), whereas others (12) found no evidence of LV diastolic dysfunction at rest in longterm type 1 diabetic patients. It has been suggested that LV dysfunction in type 1 diabetic patients may be related to structural changes of the myocardium or to concomitant diabetic autonomic neuropathy (DAN) (13).…”

mentioning

confidence: 94%

Left Ventricular Systolic and Diastolic Function in Normotensive Type 1 Diabetic Patients With or Without Autonomic Neuropathy

Didangelos

Arsos²,

Karamitsos³

et al. 2003

Diabetes Care

View full text Add to dashboard Cite

OBJECTIVE -To investigate the relation between diabetic autonomic neuropathy (DAN) and left ventricular (LV) function in type 1 diabetic patients. RESEARCH DESIGN AND METHODS-A total of 57 type 1 diabetic patients free of coronary artery disease and arterial hypertension were studied. Diagnosis of DAN was established by autonomic nervous function (ANF) tests, and LV systolic and diastolic functions were assessed by radionuclide ventriculography at rest.RESULTS -There were 24 patients who had definite DAN, established by the presence of two or more abnormal ANF tests, and 33 subjects were without DAN. DAN patients had impaired LV filling pattern, obvious by a reduced peak filling rate (3.1 Ϯ 1.1 vs. 3.7 Ϯ 0.7 end-diastolic volume [EDV]/s, P ϭ 0.011) and first third filling fraction (35.3 Ϯ 19.5 vs. 50.8 Ϯ 16%, P ϭ 0.002) as well as an increased time to peak filling (159.4 Ϯ 45.1 vs. 134.2 Ϯ 33.4 ms, P ϭ 0.02) after correction for age and heart rate. There were no differences between the two groups with regard to ejection fraction, cardiac output, and cardiac index, whereas the peak emptying rate was greater in DAN patients (4.1 Ϯ 0.8 vs. 3.6 Ϯ 0.8 EDV/s, P ϭ 0.019), suggesting LV hypercontractility. DAN patients had an increased heart rate (83.4 Ϯ 11.9 vs. 72.7 Ϯ 9.3 bpm, P ϭ 0.001) and slightly higher systolic blood pressure. As a result, LV working load at rest was higher in DAN patients (11,109 vs. 9,096 bpm ϫ mmHg, P Ͻ 0.001). Moreover, a correlation was found between abnormal LV systolic and diastolic indexes and the number of abnormal ANF tests.CONCLUSIONS -At rest, DAN patients have impaired LV filling pattern, slightly increased LV systolic function, and a higher LV working load, in comparison to non-DAN type 1 diabetic patients. Diabetes Care 26:1955-1960, 2003C linical and epidemiological studies have confirmed that patients with diabetes appear susceptible to heart failure, which is the leading cause of death in these patients (1). Impairment of left ventricular (LV) function is frequent in patients with type 1 diabetes, even in the absence of ischemic, hypertensive, or valvular heart disease (2). Possible mechanisms for a specific diabetic cardiomyopathy include abnormalities of small intramural coronary vessels, deposition of collagen, and lipids and metabolic derangements that alter actomyosin and myosin adenosine triphosphatase activities (3). Although histopathologic and biochemical evidence for a distinct diabetic cardiomyopathy is available, it remains unclear whether these pathologic processes may cause significant LV systolic or diastolic dysfunction. Numerous studies have reported normal LV systolic function at rest in most type 1 diabetic patients (4), whereas others have suggested increased LV systolic function (5,6). Several investigators have shown abnormal LV diastolic function in the majority of type 1 diabetic patients (7-11), whereas others (12) found no evidence of LV diastolic dysfunction at rest in longterm type 1 diabetic patients. It has been suggested that LV dysfunction in type...

show abstract

Cardiomyopathy in childhood diabetes mellitus: incidence, time of onset, and relation to metabolic control

Cited by 31 publications

References 26 publications

Echocardiographic load-independent indices of contractility in children and adolescents with type I diabetes: Effect of metabolic control and insulin on left ventricular performance

Echocardiographic load-independent indices of contractility in children and adolescents with type I diabetes: Effect of metabolic control and insulin on left ventricular performance

The Development of Heart Failure in Patients With Diabetes Mellitus and Pre-Clinical Diastolic Dysfunction

Left Ventricular Systolic and Diastolic Function in Normotensive Type 1 Diabetic Patients With or Without Autonomic Neuropathy

Contact Info

Product

Resources

About