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European Heart Journal 1998 19(11):1735-1739; doi:10.1053/euhj.1998.1090
Copyright © 1998 by the European Society of Cardiology.
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Increased left ventricular systolic function in insulin dependent diabetic patients with normal albumin excretion

E.H. Christiansenf1, H. Mølgaard, P.D. Christensen, K.E. Sørensen, C.K. Christensen and C.E. Mogensen

*Department of Cardiology, Skejby University Hospital, Skejby Sygehus
Department of Diabetes and Endocrinology, Aarhus kommunehospital, Aarhus University Hospital, Aarhus, Denmark

accepted March 30, 1998

Alterations in cardiovascular function may be an aetiological factor for the development of microalbuminuria in patients with insulin-dependent diabetes mellitus. We studied cardiac function with echocardiography in relation to the degree of albuminuria in 27 insulin-dependent diabetes mellitus patients and 13 healthy subjects. Patients were grouped according to urinary albumin excretion:<20µg.min–1(normoalbuminuric), and 20 to 200µg.min–1(microalbuminuric). None were or had been treated with cardiovascular drugs. The normoalbuminuric patients had a higher heart rate, mean velocity of circumferential shortening, stroke velocity index (a measure of contractility), and aortic peak velocity than controls. No difference in diastolic function was present. In the microalbuminuric group, the stroke velocity index was comparable to values observed in healthy subjects. The increased systolic performance (heart rate and contractility) may contribute to the renal hyperperfusion and glomerular hyperfiltration observed in insulin-dependent diabetes mellitus patients before the development of micro- and in turn macroalbuminuria. The possible cause–effect mechanisms should be further studied, as preventive medical treatment of the hypercontractile heart is possible. In conclusion, cardiac contractility is increased in insulin-dependent diabetes mellitus patients with normoalbuminuria and returns to levels observed in healthy subjects when microalbumin-uria develops.The European Society of Cardiology

Key Words: Type 1 (insulin-dependent) diabetes • heart rate • left ventricular systolic and diastolic function • albumin excretion • cardiovascular function • echocardiography

f1 Correspondence: Evald Høj Christiansen, MD, PhD, Department of Cardiology, Skejby University Hospital, DK-8200 Aarhus N, Denmark. E-mail:skejehc@aau.dk


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