Diastolic dysfunction of left ventricule in diabetic cardiomyopathy

DC appears in cardiological literature from seventies. This term is used to determine the disease of a heart muscle, by definition not connected with presence of coexisting, hemodynamicaly important macrovascular coronary arteriosclerosis, arterial hypertension, valvulopathy of any origin or alcoholic disease of mycardium. This disease appears very early, in both types of diabetes, and in its first phase the disease is clinically asymptomatic. The goal of this paper is to present the characteristics of diastolic dysfunction of the left vetricule in DC. We have analyzed numerous clinical and echocardiographic parameters of two groups of similar age, gender and other characteristics: experimental group (32 patients with diabetes mellitus) and control group (40 patients without diabetes). The assessment of the diastolic function of the left vetricule was done echocardiographically through transmitral flow in diastola by the application of pulse Doppler. In the group with diabetes the patients had lower values for velocities of both, early and late diastolic filling of the left ventricule. The velocity of early diastolic filling of the left ventricule showed statistically important difference; acceleration and deceleration time of the early filling wave was lower in the experimental group. In the group with diabetes 18 patients had diastolic dysfunction of the left ventricule (56,25 %) versus 5 patients from the control group (12,5 %). While the patients from the control group had the very modest form of diastolic dysfunction (slowed relaxation) in the group with diabetes 21 % of the patients had the strongest form of diastolic dysfunction (restriction). All diabetics with systolic dysfunction of the left ventricule had also diastolic dysfunction, while 4 diabetics had only diastolic dysfunction. The average age of patients with systolic dysfunction was 40.4 years while the patients with diastolic dysfunction of the left ventricule had the average age of 36.1 years. The first symptoms of DC appear shortly after the existence of diabetes, in both types of diabetes. Diastolic dysfunction of the left ventricule usually appears before systolic dysfunction, and most frequently they appear together. The first changes in DC appear on the septal wall, resulting with disorder of the left ventricule relaxation and echocardiographicaly visible diastolic dysfunction of the left ventricule. Diabetics need regular cardiological examination in the early phase of the disease, in order to find out diastolic dysfunction and to prevent heart failure.