LEFT-VENTRICULAR FUNCTION AND DIMENSIONS IN NEWLY DIAGNOSED NON-INSULIN-DEPENDENT DIABETES-MELLITUS

Left ventricular (LV) function and dimensions were assessed with Doppler and M-mode echocar diography in 26 men and 17 women with newly di agnosed non-insulin-dependent diabetes mellitus, and in 13 healthy control men and 13 women. The diabetic men had lower peak filling rate normalized to mitral stroke volume than the control men (mean +/- standard error of the mean, 4.2 +/- 0.1 vs 4.9 +/- 0.3 stroke volume/s, p <0.01). The diabetic women had increased LV mass (102 +/- 12 vs 86 +/-8 g/m2, p <0.01) and decreased fractional shortening (34 +/- 1 vs 38 +/- 1%, p <0.05) when compared with control women. At 3 and 15 months, 23 diabetic men and 15 women were reexamined. Concomitantly with decreasing blood glucose levels, fractional shortening improved mainly during the first 3 months and was significantly higher in both diabetic men (36 +/- 2 vs 30 +/- 2%, p <0.05) and women (38 +/- 1 vs 34 +/- 1%, p <0.05) at 15 months than at baseline. In the diabetic men, peak filling rate increased from 4.3 +/- 0.1 stroke volume/s at baseline to 4.8 +/- 0.2 stroke volume/s at 15 months (p <0.05). At 15 months, peak filling rate was correlated (r = 0.61, p less-than-or-equal-to 0.001) with autonomic nervous function assessed as heart rate variability during deep breathing test in diabetic men who also showed an inverse correlation between LV hypertrophy and heart rate variability throughout the follow-up. The relation between peak filling rate and heart rate variability was, however, independent of LV wall thickness, age, glycemic control, body mass index and cardiovascular diseases. These preliminary results demonstrate that both systolic and diastolic function improve concomitantly with declining blood glucose levels in patients with newly diagnosed non-insulin-dependent diabetes mellitus. Hyperglycemia may have a more direct adverse effect on LV systolic function than on LV filling that is related to autonomic nervous function.