英文誌(2004-)
Original Article(原著)
(0416 - 0424)
糖尿病心の左室流入および駆出血流動態の分析
Analysis of Inflow and Ejection Flow Dynamics of the Left Ventricle in Diabetics
佐倉 英一郎, 岡本 光師, 横手 祐司, 島本 博幸, 山形 東吾, 網岡 英世, 橋本 正樹, 高橋 路子, 土岡 由紀子, 松浦 秀夫, 梶山 梧朗
Eiichiro SAKURA, Mitsunori OKAMOTO, Yuji YOKOTE, Hiroyuki SHIMAMOTO, Togo YAMAGATA, Hideyo AMIOKA, Masaki HASHIMOTO, Michiko TAKAHASHI, Yukiko TSUCHIOKA, Hideo MATSUURA, Goro KAJIYAMA
広島大学医学部第一内科
The First Department of Internal Medicine, Hiroshima University School of Medicine
キーワード : Diabetic cardiomyopathy, Pulsed Doppler echocardiography, Diastolic property
The left ventricular blood flow dynamics were investigated in 89 diabetics and 26 normals by pulsed Doppler echocardiography with special reference to complication of microangiopathy (MA) and/or hypertension (HT).
Forty three cases of the diabetics had MA and 34 cases had HT. MA was defined as presence of persistent proteinuria and/or diabetic retinopathy. The mitral and ejection flow patterns were recorded from the apical approach.
1) Acceleration and deceleration rate in the rapid filling phase significantly decreased even in the diabetics without MA and HT (661±160, 268±127 cm/sec²) compared with controls (728±145, 328±134 cm/sec²). The reduction in these indices was the greatest in cases with both MA and HT (550±131, 226±86 cm/sec²). The ratio of the peak velocity in the atrial contraction phase to that in the rapid filling phase significantly increased in the diabetics. 2) There was no significant difference in mean Vcf between controls (1.19±0.16 circ/sec) and cases with no complication (1.16±0.16 circ/sec). However, it significantly decreased in the diabetics with MA (1.04±0.20 circ/sec) and further in cases with both MA and HT (0.96±0.23 circ/sec). 3) The ratios of PEP/ET and ACT/ET showed no significant differences between the diabetics and controls. These results suggest that the impairment of left ventricular relaxation and distensibility in early diastole and compensatory augmentation of atrial contraction in late diastole may occur even in the early stage of diabetes mellitus and systolic dysfunction appears in the cases with microangiopathy. Hypertension deteriorates these abnormalities.