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Diastolic dysfunction in diabetic normotensive patients, regardless of the presence of microangiopathy

OBJECTIVE: To assess the Doppler-echocardiographic changes in normotensive patients with type II diabetes mellitus, in the presence or absence of signs of microangiopathy. METHODS: Patients with type II diabetes mellitus were submitted to funduscopy contrasted with fluorescein and dosage of microalbuminuria for diagnose of microangiopathy and divided into two groups: DMII (patients without microangiopathy, n=19) and DM+A (patients with microangiopathy, n=13). All of them were submitted to a Doppler-echocardiography and the results were compared with normotensive patients of same sex and age (group C, n=20), by using the ANOVA, followed by the test of Tukey. In all comparisons the significance level p<0.05 was adopted. RESULTS: There were no differences among the groups regarding the systolic function indicators or left ventricular mass. Differences compatible with diastolic dysfunction in the two groups of diabetic were observed, regardless of the presence of microangiopathy, which showed significantly higher values of the times of isovolumetric relaxation of the left ventricle (TIRLV, ms): (DMII= 97±22.2; DM+A= 107±28.2 and C= 80±10.7; p<0.05), and lower values of the maximum speeds of the wave of fast ventricular filling (E, cm/s): (DMII= 69±17.5; DM+A= 75±19.7 and C= 84±14.5, p<0.05 between DMII and C). There was no difference among the groups concerning the E/A rate. CONCLUSION: Normotensive patients with type II diabetes mellitus and without clinical signs of cardiovascular compromising showed signs of diastolic dysfunction, non-associated to the presence of microangiopathy.

echocardiogram; left ventricle; cardiomiopathy; diabetes mellitus


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