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Monteagudo PT, Moisés VA, Kohlmann O, et al. Influence of autonomic neuropathy upon left ventricular dysfunction in insulin-dependent diabetic patients. Clin Cardiol. 2000;23(5):371-5doi: 10.1002/clc.4960230513.
Monteagudo, P. T., Moisés, V. A., Kohlmann, O., Ribeiro, A. B., Lima, V. C., & Zanella, M. T. (2000). Influence of autonomic neuropathy upon left ventricular dysfunction in insulin-dependent diabetic patients. Clinical cardiology, 23(5), 371-5. https://doi.org/10.1002/clc.4960230513
Monteagudo, P T, et al. "Influence of autonomic neuropathy upon left ventricular dysfunction in insulin-dependent diabetic patients." Clinical cardiology vol. 23,5 (2000): 371-5. doi: https://doi.org/10.1002/clc.4960230513
Monteagudo PT, Moisés 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 May;23(5):371-5. doi: 10.1002/clc.4960230513. PMID: 10803447; PMCID: PMC6655188.
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Clin Cardiol. 2000 May;23(5):371-5. doi: 10.1002/clc.4960230513.

Influence of autonomic neuropathy upon left ventricular dysfunction in insulin-dependent diabetic patients.

Clinical cardiology

P T Monteagudo, V A Moisés, O Kohlmann, A B Ribeiro, V C Lima, M T Zanella

Affiliations

  1. Department of Medicine, Escola Paulista de Medicina, UNIFESP, São Paulo, Brazil.

PMID: 10803447 PMCID: PMC6655188 DOI: 10.1002/clc.4960230513

Abstract

BACKGROUND: Diabetic cardiomyopathy is a well-defined complication of diabetes that occurs in the absence of ischemic, vascular, and hypertensive disease.

HYPOTHESIS: The study was undertaken to test the relationship among autonomic neuropathy (AN), 24-h blood pressure (BP) profile, and left ventricular function.

METHODS: Nineteen type-1 diabetic patients underwent autonomic tests and echocardiographic examination. Patients were divided according to the presence (AN+) or absence (AN-) of AN.

RESULTS: In the AN+ group (n = 8), the E/A ratio at echo was lower than in the AN- group (n = 11) (1.1 +/- 0.3 vs. 1.6 +/- 0.3; p < 0.005). Systolic and diastolic BP reductions during sleep were smaller in the AN+ than in the AN- group (6.6 +/- 6.6 vs. 13.0 +/- 4.3%; p < 0.03 for systolic and 12.8 +/- 6.8 vs. 20.0 +/- 4.0% for diastolic BP reduction; p < 0.03, respectively). Considering all patients, the E/A ratio correlated inversely with awake diastolic BP (r - 0.63; p = 0.005); sleep systolic BP (r - 0.48; p = 0.04), and sleep diastolic BP (r - 0.67; p = 0.002). The AN correlated with diastolic interventricular septum thickness (r 0.57; p = 0.01), sleep systolic BP (r 0.45; p = 0.05), sleep diastolic BP (r 0.54; p = 0.02), and correlated inversely with systolic and diastolic sleep BP reduction (r - 0.49; p = 0.03 and r - 0.67; p = 0.002, respectively). Finally, E/A ratio and AN score correlated between themselves (r - 0.6; p = 0.005).

CONCLUSION: Our results suggest that left ventricular diastolic dysfunction may be detected very early in type-1 diabetic patients with AN. Parasympathetic lesion and nocturnal elevations in BP could be the link between AN and diastolic ventricular dysfunction.

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