Left ventricular filling determined by Doppler echocardiography in diabetes mellitus

Abstract Diabetes mellitus is associated with a high mortality from cardiac disease attributed to coronary artery atherosclerosis or systemic hypertension. Increasing evidence indicates that cardiac dysfunction occurs even in diabetics with normal coronary arteries. 1–3 In 1972, Rubier et al 1 reported 4 adult-onset diabetic patients who had cardiomegaly and congestive heart failure in the absence of major coronary artery disease or hypertension. Hamby et al 2 observed a high incidence of diabetes mellitus in their series of patients with idiopathic cardiomyopathy. Furthermore, several investigators have shown that abnormalities of left ventricular (LV) diastolic function are common even in diabetics without clinical manifestations of congestive heart failure. 3–6 Whether these abnormalities result from a microangiopathic process in the heart or from metabolic abnormalities inherent to diabetes mellitus is still unclear. 7 Measurement of transmitral flow velocity by Doppler echocardiography has recently been shown to be useful in identifying abnormal LV diastolic filling properties in a variety of disease states. 8–11 This study evaluates the diastolic LV filling characteristics in patients with adult-onset diabetes mellitus using pulsed Doppler echocardiography.