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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
6
pubmed:dateCreated
2001-3-5
pubmed:abstractText
In this study we assess the mechanisms of exercise-induced left ventricular (LV) dysfunction in asymptomatic patients with Type 1 diabetes mellitus (T1DM) without coronary artery disease. Fourteen patients and 10 volunteers were enrolled. LV volume, LV ejection fraction (LVEF) and end-systolic wall stress were calculated by two-dimensional echocardiography at rest and during isometric exercise. Myocardial iodine-123 metaiodobenzylguanidine (MIBG) scintigraphy was performed to assess adrenergic cardiac innervation. Diabetic subjects were classified into group A (n=7), with an abnormal LVEF response to handgrip (42 +/- 7%), and group B (n=7), with a normal response (72 +/- 8%). Baseline LVEF was normal in both group A and B patients. In group A patients, the LV circumferential wall stress-LVEF relation showed an impairment in LVEF disproportionate to the level of LV after load. No significant changes in LVEF occurred during dobutamine, whereas post-extrasystolic potentiation (PESP) significantly increased LVEF (60 +/- 6% vs 74 +/- 6%,p < 0.001); PESP at peak handgrip normalized the abnormal LVEF (42 +/- 7% vs 72 +/- 5%, p < 0.001); and MIBG uptake normalized for body weight or for LV mass was lower than in normal subjects (1.69 +/- 0.30 vs 2.98 +/- 0.82 cpm/MBq per g,p = 0.01) and group B diabetic patients (vs 2.79 +/- 0.94 cpm/MBq per g,p = 0.01). A linear correlation between LVEF at peak handgrip and myocardial MIBG uptake normalized for LV mass was demonstrated in the study patients. A defective blunted recruitment of myocardial contractility plays an important role in determining exercise LV dysfunction in the early phase of diabetic cardiomyopathy. This abnormal response to exercise is strongly related to an impairment of cardiac sympathetic innervation.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Dec
pubmed:issn
0394-3402
pubmed:author
pubmed:issnType
Print
pubmed:volume
13
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
346-9
pubmed:dateRevised
2004-11-17
pubmed:meshHeading
pubmed:year
2000
pubmed:articleTitle
Myocardial dysfunction and adrenergic innervation in patients with Type 1 diabetes mellitus.
pubmed:affiliation
Department of Clinical and Experimental Medicine and of Nuclear Medicine, University of Padova, Italy.
pubmed:publicationType
Journal Article