You are here

Tip II Diyabetes Mellituslu Hastalarda Kardiyak Otonom Nöropati ile Diyastolik Kalp Fonksiyonlarının İlişkisi

The Relationship Between Cardiac Autonomic Neuropathy and Diastolic Heart Function in Patients with Type II Diabetes Mellitus

Journal Name:

Publication Year:

Abstract (2. Language): 
Since it shows important differences in circumstances of treatment and prognosis the early diagnosed diastolic dysfunction, compared to systolic dysfunction presents much more importance in terms of preventive practice. In this study we examined the association of cardiac autonomic neuropathy (CAN) and diastolic dysfunction that are important predictors for prognosis in diabetic patients who do not have findings of obvious cardiac disease. In the study 33 patients with type 2 diabetes mellitus were enrolled. Healthy 12 persons were taken as the control group. CAN was evaluated with Ewing test and the diastolic heart functions were evaluated with echocardiographic examination. Group 1 constituted 15 CAN (-) people with Ewing score<1 and the group 2 constituted the 18 CAN (+) with Ewing score ≥1. A wave amplitude was higher, E/A was smaller and the deceleration time was longer in group 2 compared to group 1 and the control group (p<0.05). These findings show that the diastolic dysfunction is more prominent in group 2. In this study we showed that an association of CAN and diastolic dysfunction exists in patents with type 2 diabetes mellitus.
Abstract (Original Language): 
Hem tedavi hem de prognoz açısından önemli farklılıklar gösterdiği için erken dönemde saptanan diyastolik disfonksiyon, sistolik disfonksiyona göre koruyucu hekimlik açısından daha büyük önem arz etmektedir. Bu nedenle çalışmamızda aşikâr kardiyak hastalık bulguları olmayan diyabetik hastalarda prognoz için önemli belirteçler olan kardiyak otonom nöropati (KON) ile diyastolik disfonksiyonun ilişkisini araştırdık. Çalışmaya tip 2 diabetes mellitus tanısı olan 33 hasta dahil edildi. Sağlıklı yaş uyumlu 12 kişi kontrol grubu olarak alındı. KON Ewing testi ile, diyastolik kalp fonksiyonları ekokardiyografi ile değerlendirildi. Ewing skoru<1 olan KON (-) 15 olgu grup 1’i, ≥1 olan KON (+) 18 olgu grup 2’yi oluşturdu. Grup 2’de hem grup 1, hem de kontrol grubuna göre A dalga amplitüdü daha yüksek, E/A oranı daha küçük ve deselerasyon zamanı daha uzun (p<0.05) bulundu. Bu bulgular grup 2’de diyastolik disfonksiyonun daha belirgin olduğunu göstermektedir. Çalışmamızın sonucunda tip II diyabetli olgularda KON ile diyastolik disfonksiyon arasında ilişki olduğunu gösterdik.
55-59

REFERENCES

References: 

1. King H, Aubert RE, Herman WH. Global burden of diabetes,1995-2025: prevalence, numerical estimates, and projections. Diabetes Care 1998; 21: 1414-31.
2. Boyl JP, Honeycut AA, Narayan KM et al. Projection of
diabetes burden through 2050: impact of changing demography and disease prevalence in the US. Diabetes Care 2001; 24:
1936 – 40.
3. McGuire DK, Rao SV. Epidemiology of diabetes mellitus and
cardiovascular disease In: Handbook of Diabetes mellitus and
Cardiovascular Disease Marso S.P (eds) 1.Edition Remedica
Publising Limited 2003 1 -24.
4. Masharani U, Karam JH., German SM, Chronic Complications of Diabetes Mellitus In: Greenspan FS, Gardner DG
(eds) Basic& Clinical Endocrinology 7th Edition Lange Medical Books/McGraw Hill Companies; 2004 723 – 32.
5. American Diabetes Association. Consensus Development
Conference on the diagnosis of coronary heart disease in the
people with diabetes. Diabetes Care 1998; 21: 1551 – 59.
6. Maser R., Pfeifer M., Dorman J., Diabetic autonomic neuropathy and cardiovascular risk. Arch Int Med. 1990; 150: 1218 -
22.
7. Vinik A.I, Zola B.E. Diabetik otonom nöropatinin kardiyovasküler sistem üzerine etkileri In: Diabetes mellitus ve Tip II Diyabetes Mellituslu Hastalarda Kardiyak Otonom Nöropati
59
Kardiyovasküler Hastalıklarda Yeni Ufuklar (New Horizons
in Diabetes Mellitus & Cardiovascular Disease) Çvr editör
Oğuz A., (Eds. Schwartz C.J., Born G.V.R Current Science
1995 London) CSA yayınevi İstanbul 1999 169-79.
8. Yeşil S. Diyabetik Nöropati ve Tedavisi. Endokrinoloji (Diabetes Mellitus Özel Sayısı) 2003; 1 (3); 232–36.
9. Singh N. Diabetes, Heart Rate, and Mortality. J Cardiovasc
Pharmacol Therapeut 2002; 7: 117-29.
10. Vinik AI, Park TS, Stansberry KB, Pittenger GL. Diabetic
neuropathies Diabetologia 2000; 43; 957-73.
11. Tomlinson DR., Fernyhough P, Diemel LT, Stevens EJ. New
Horizons in Diabetes Mellitus & Cardiovascular Disease. Eds.
Schwartz C.J., Born G.V.R Current Science 1995 London
182-93.
12. Vinik A.I, Erbaş T., Recognizing and treating diabetic neuropathy Cleveland Clinic Journal of Medicine 2001; 68(11):
928-44.
13. Bloomgarden Z.T. Cardiovascular Disease in Type 2 Diabetes.
Diabetes Care. 1999; 22 (10): 1739 - 44.
14. Devereux RB, Roman MJ, Paranicas M,. O’Grady MJ, Lee
ET, Welty TK, Fabsitz RR, Robbins D, Rhoades ER,. Howard
BV: Impact of Diabetes on Cardiac Structure and Function
The Strong Heart Study Circulation. 2000; 101: 2271-76.
15. Singh JP, Larson MG, O’Donnell CJ, Wilson PF, Tsuji H,
Lloyd-Jones DM, Levy D, Association of Hyperglycemia
With Reduced Heart Rate Variability (The Framingham Heart
Study) Am J Cardiol 2000; 86: 309-12.
16. Hilsted J, Galbo H, Christensen NJ, Parving HH, Benn J.
Haemodynamic changes during graded exercise in patients
with diabetic autonomic neuropathy. Diabetologia 1982; 22:
318–23.
17. Fein FS, Sonnenblick EH. Diabetic cardiomyopathy. Cardiovasc Drugs Ther 1994; 8: 65–73.
18. Piccini J.P., Klein L., Gheorghiade M., Bonow R.O., New
Insight into Diastolic Heart Failure: Role of Diabetes Mellitus
Am J Med 2004; 116(5A) 64S-75S.
19. Taskiran M, Rasmussen V, Rasmussen B, Fritz-Hansen T,
Larsson HB, Jensen GB,Hilsted J Left ventricular dysfunction
in normotensive Type 1 diabetic patients: the impact of autonomic neuropathy. Diabet Med. 2004;21:524-30.
20. Şekuri C, Kurhan Z, Tavlı T, Bayturan Ö, Ütük O, Bilge AR,
Tıkız H, Tezcan UK. Akut Q-Dalgalı Miyokard İnfarktüsünde
Miyokardiyal Performans İndeksi ve Mitral E Dalga
Deselerasyon Zamanı Arasındaki İlişki. Anadolu Kardiyol
Derg 2004; 4: 108-13.
21. Monteagudo PT, Moises VA, Kohlmann O, Ribeiro AB, Lima
VC, Zanella MT. Influence of autonomic neuropathy upon left
ventricular dysfunction in insulin-dependent diabetic patients.
Clin Cardiol 2000; 23: 371–75.
22. Irace L, Iarussi D, Guadagno I, Tedesco MA, Perna B, Ratti G
et al. Left ventricular performance and autonomic dysfunction
in patients with long-term insulin-dependent diabetes mellitus.
Acta Diabetol 1996; 33: 269–73.
23. Leakso M.Textbook of Type 2 Diabetes Goldstein B.J., Mü-
ler-Wieland D.(eds) 1.edition. Taylor Francis Group 2003 1-
12.
24. Coopan R. Diabetes mellitusta glikoz kontrolünün hedefleri ve
mantığı ve glikoz monitarizasyonu In Textbook of Type 2
Diabetes Goldstein B.J., Müler-Wieland D.(eds)
(Çvr.edt.Akman A.C).1.edition. Taylor Francis Group 2003
29-38.
25. Schannwell CM, Schneppenheim M, Perings S, Plehn G,
Strauer BE. Left ventricular diastolic dysfunction as an early
manifestation of diabetic cardiomyopathy. Cardiology
2002;98(1-2): 33-9.

Thank you for copying data from http://www.arastirmax.com