No evidence for left ventricular diastolic dysfunction in asymptomatic normotensive type 2 diabetic patients: a case-control study with new echocardiographic techniques

• Published in: Diabetes & metabolism 2007-02, Vol.33 (1), p.61-67
• Main Authors: Cosson, S, Kevorkian, J.-P, Virally, M.-L, Henry, P, Laloi-Michelin, M, Meas, T, Beaufils, P, Guillausseau, P.-J
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Blood Pressure; Cardiology. Vascular system; Diabetes Mellitus, Type 2 - diagnostic imaging; Diabetes Mellitus, Type 2 - physiopathology; Diabetes. Impaired glucose tolerance; Diabète de type 2; Diastolic function; Doppler tissulaire; Echocardiography; Echocardiography, Doppler; Echocardiography, Doppler, Color; Endocrine pancreas. Apud cells (diseases); Endocrinology & Metabolism; Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Fonction diastolique ventriculaire gauche; Heart; Heart failure, cardiogenic pulmonary edema, cardiac enlargement; Heart Ventricles - diagnostic imaging; Humans; Internal Medicine; Male; Manœuvre de Valsalva; Medical sciences; Middle Aged; Pulmonary Circulation; Tissue Doppler imaging; Type 2 diabetes; Valsalva Maneuver; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Dysfunction, Left - epidemiology; Ventricular Function, Left - physiology; Vitesse de remplissage; Échocardiographie
• ISSN: 1262-3636; 1878-1780
• DOI: 10.1016/j.diabet.2006.11.003

Abstract Objective We sought to determine whether abnormalities of left ventricular structure and function could be detected in asymptomatic type 2 diabetic patients free of cardiovascular complications. Research design and methods We compared 48 subjects with type 2 diabetes (34 men, 50 ± 6 years) without hypertension, coronary artery disease and microangiopathic complications with 30 age-matched healthy controls. Left ventricular diastolic function was assessed by conventional Doppler echocardiography and new echocardiographic techniques (tissue Doppler imaging, color M-mode propagation velocity). A pseudonormal (PN) pattern of left ventricular filling was screened by several methods including Valsalva maneuver. Results Systolic function was normal in all patients. There was no significant difference in conventional and new echocardiographic Doppler indices of diastolic function between patients and control subjects. A PN diastolic function frequently suggested by the Valsalva maneuver (20 patients) was excluded using the new parameters. Conclusions Diastolic dysfunction is not as frequent as previously described in selected patients with type 2 diabetes free of microangiopathic complications. New Doppler echocardiographic methods provide, in contrast with the Valsalva maneuver, a reliable estimate of diastolic function and should be incorporated in the non-invasive screening for diabetic cardiomyopathy.