Radionuclide ventriculographic evaluation of exercised leftventricular performance in asymptomatic diabetic patients
Radionuclide ventriculography was made in 49 asymptomatic diabetic patients, aged 30-70 years, to investigate cardiac function. Comparisons were made with 33 age- and sex-matched non-diabetic controls. Radionuclide ventriculography was performed at rest and during dynamic exercise by multigraded, su...
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| Published in | Journal of Nippon Medical School Vol. 58; no. 5; pp. 501 - 506 |
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| Main Authors | , |
| Format | Journal Article |
| Language | Japanese |
| Published |
The Medical Association of Nippon Medical School
1991
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| ISSN | 0048-0444 1884-0108 |
| DOI | 10.1272/jnms1923.58.501 |
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| Abstract | Radionuclide ventriculography was made in 49 asymptomatic diabetic patients, aged 30-70 years, to investigate cardiac function. Comparisons were made with 33 age- and sex-matched non-diabetic controls. Radionuclide ventriculography was performed at rest and during dynamic exercise by multigraded, supine bicycle ergometer. The resting left ventricular ejection fractions were similar between the diabetic patients and control subjects. No significant rise in the left ventricular ejection fractions during dynamic exercise was observed in the diabetic patients [58.4±9.8% (mean±SD) to 60.3±9.9] . In the control subjects, the left ventricular election fractions increased during dynamic exercise [59.3±8.4 to 63.0±11.4 (p<0.05) ]. Peak ejection rates were similar in both groups at rest [-2.62±0.64 (s-1) vs-2.66±0.52] and during dynamic exercise [-3.25±0.74 vs-3.23±0.90] . Time to end-systole were similar in both groups at rest [315±42 (ms) vs 309±42] and during dynamic exercise [258±37 vs 262±37]. The resting peak filling rates were similar in both groups [2.27±0.62 (s-1) vs 2.45±0.58], and the peak filling rates increased (p<0.001) during dynamic exercise in both groups [2.68±0.61 vs 3.28±0.74] . However, the percent changes of the peak filling rates were significantly lower in diabetic patients (p<0.001). In four of the diabetic patients, hypokinesis of the intraventricular septum was observed. No relation was indicated between the percent changes of the left ventricular ejection fraction and the value of HbA1c in the diabetic patients. These results suggest that diabetic patients have less cardiac reserved performance. |
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| AbstractList | Radionuclide ventriculography was made in 49 asymptomatic diabetic patients, aged 30-70 years, to investigate cardiac function. Comparisons were made with 33 age- and sex-matched non-diabetic controls. Radionuclide ventriculography was performed at rest and during dynamic exercise by multigraded, supine bicycle ergometer. The resting left ventricular ejection fractions were similar between the diabetic patients and control subjects. No significant rise in the left ventricular ejection fractions during dynamic exercise was observed in the diabetic patients [58.4±9.8% (mean±SD) to 60.3±9.9] . In the control subjects, the left ventricular election fractions increased during dynamic exercise [59.3±8.4 to 63.0±11.4 (p<0.05) ]. Peak ejection rates were similar in both groups at rest [-2.62±0.64 (s-1) vs-2.66±0.52] and during dynamic exercise [-3.25±0.74 vs-3.23±0.90] . Time to end-systole were similar in both groups at rest [315±42 (ms) vs 309±42] and during dynamic exercise [258±37 vs 262±37]. The resting peak filling rates were similar in both groups [2.27±0.62 (s-1) vs 2.45±0.58], and the peak filling rates increased (p<0.001) during dynamic exercise in both groups [2.68±0.61 vs 3.28±0.74] . However, the percent changes of the peak filling rates were significantly lower in diabetic patients (p<0.001). In four of the diabetic patients, hypokinesis of the intraventricular septum was observed. No relation was indicated between the percent changes of the left ventricular ejection fraction and the value of HbA1c in the diabetic patients. These results suggest that diabetic patients have less cardiac reserved performance. |
| Author | Hara, Fumio Fujii, Yusuke |
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| References | 18) Ledet, T.: Histological and histochemical change in the coronary arteries of old diabetic patients. Diabetologia, 4, 268-272, 1968. 22) Srivastav, A.K. and Anand-Srivastava, M.B.: Streptozotocin induced diabetes and hormon sensitivity of adenylate cyclase in rat myocardial sarcolemma, aorta and liver. Biochem. Pharmacol., 34, 2013-2017, 1985. 15) 斎木茂樹: 若年者糖尿病患者における心機能異常; 自律神経抑制および運動負荷の影響. Jpn. Circ. J., 42, 1359-1371, 1978. 2) Airaksinen, J., Ikaheimo, M, Kaila, J., Linnaluoto, M. and Takkunen, J.: Impaired left ventricular filling in young diabetics. Acta Med. Scand., 216, 509-516, 1984. 20) Iimura, T., Nagata, E., Watari, S., Kawanishi, M., Kawamura, M., Ohkubo, T. and Nagano, M.: Calcium binding of sarcolemma and sarcoplasmic reticulum in alloxan diabetes. J. Mol. Cell Cardiol., 15, 243-247, 1983. 1) Shapira, L.: A prospective study of heart disease in diabetes mellitus. Quart. J. Med., 209, 55-68, 1984. 3) Hamby, L., Zoneraich, S. and Sherman, L.: Diabetic cardiomyopathy. J. Am, Med. Assoc., 229, 1749-1754, 1974. 19) Dillman, W.H.: Dialaetes mellitus induces changes in cardiacmyosin of the rat. Diabetes, 29, 579-582, 1980. 6) 鯵坂隆一, 飯田要, 松本龍馬, 藤田亮宣, 飯田啓治, 杉下靖郎, 伊藤巌, 武田徹, 畠山六郎, 外山比南子, 秋貞雅祥: イソプロテレノ一ル負荷心プールシンチグラフィーによる虚血性心疾患の左心機能評価. 心臓, 18, 255-231, 1986. 21) Savarese, J.J. and Berkowitz, B.A.: Beta-adrenergic receptor decrease in diabetic rat heart. Life Sci., 25, 2075-2078, 1979. 12) Shapiro, L.M., Howat, A.P. and Calter, M.M.: Left ventriclar function in diabetes mellitus I; Methodology and prevalence and spectrum of abnormalities. Br. Heart J., 45, 122-128, 1981. 9) Ahmed, S.S., Jaferi, G.A, Narang, R.M, and Regan, T.J.: Preclinical abnomalitiy of left ventricular function in diabetes mellitus. Am. Heart. J., 89, 153-158, 1975. 4) 成田充啓, 栗原正, 村野謙一, 宇佐美暢久, 本田稔, 金尾啓右: 肥大心における拡張期指標の有用性; 99mTC心プールイメージングによる検討. 核医, 29, 1133-1144, 1983. 8) Kannel, W.B., Hjortland, M. and Castelli, W.P.: Role of diabetes in congestive heart failure; The Framingham study. Am. J. Cardiology, 34, 29-34, 1974. 5) 大森好晃, 加納康至, 塩谷英之, 藤谷和大, 福崎恒, 梶谷定志, 中島義治, 前田和美: 運動負荷心ブールシンチグラフィによる虚血性心疾患の左心機能評価. 心臓, 17, 112-117, 1985. 14) Goldweit, R.S., Borer, J.S., Jovanovic, L.G., Drexler, A.J., Hochreiter, C.A., Devereux, R.B. and Peterson, C.M.: Relation of hemoglobin Al and blood glucose to cardiac function in diabetes mellitus. Am. J. Cardiology 56, 642-646, 1985. 11) Shapiro, L.M.: Echocardiographic features of impaired ventricular function in diabetes mellitus. Br. Heart. J., 47, 439-444, 1982. 17) Factors, S.M.: Capillary microaneurysmsin the human diadetic heart, N. Engl. J. Med., 302, 384-388, 1980. 7) Lestert F.H., Sheffield, L.T. and Reeves, T.J.: Electrocardiographic changes in clinically normal older men following near maximal and maximal exercise. Cireulation, 36, 5-14, 1967. 16) 元田憲, 水野清雄, 布田信一, 竹田亮祐, 分枝久志, 多田明, 久田欣一: 糖尿病性心筋障害の臨床像; 210Tl心筋シンチ像, 心筋生検像を中心に. 糖尿病と心臓障害. 垂井清一郎, 杉本恒明, 永野充編, p.23-31, 医歯薬出版社, 東京, 1985. 13) Abenavoli, T., Rubler, S., Fisher, V.J., Axelrod, H.T. and Zuckerman, K.P.: Exercise testing with myocardial scintigraphy in asymptomatic diabetic males. Circulation, 63, 54-64, 1981. 10) Senevirante, B.I.B.: Diabetic cardiomyopathy; The preclinical phase. Br. Med. J., 1, 1444-1446, 1977. |
| References_xml | – reference: 19) Dillman, W.H.: Dialaetes mellitus induces changes in cardiacmyosin of the rat. Diabetes, 29, 579-582, 1980. – reference: 21) Savarese, J.J. and Berkowitz, B.A.: Beta-adrenergic receptor decrease in diabetic rat heart. Life Sci., 25, 2075-2078, 1979. – reference: 18) Ledet, T.: Histological and histochemical change in the coronary arteries of old diabetic patients. Diabetologia, 4, 268-272, 1968. – reference: 17) Factors, S.M.: Capillary microaneurysmsin the human diadetic heart, N. Engl. J. Med., 302, 384-388, 1980. – reference: 20) Iimura, T., Nagata, E., Watari, S., Kawanishi, M., Kawamura, M., Ohkubo, T. and Nagano, M.: Calcium binding of sarcolemma and sarcoplasmic reticulum in alloxan diabetes. J. Mol. Cell Cardiol., 15, 243-247, 1983. – reference: 22) Srivastav, A.K. and Anand-Srivastava, M.B.: Streptozotocin induced diabetes and hormon sensitivity of adenylate cyclase in rat myocardial sarcolemma, aorta and liver. Biochem. Pharmacol., 34, 2013-2017, 1985. – reference: 16) 元田憲, 水野清雄, 布田信一, 竹田亮祐, 分枝久志, 多田明, 久田欣一: 糖尿病性心筋障害の臨床像; 210Tl心筋シンチ像, 心筋生検像を中心に. 糖尿病と心臓障害. 垂井清一郎, 杉本恒明, 永野充編, p.23-31, 医歯薬出版社, 東京, 1985. – reference: 7) Lestert F.H., Sheffield, L.T. and Reeves, T.J.: Electrocardiographic changes in clinically normal older men following near maximal and maximal exercise. Cireulation, 36, 5-14, 1967. – reference: 11) Shapiro, L.M.: Echocardiographic features of impaired ventricular function in diabetes mellitus. Br. Heart. J., 47, 439-444, 1982. – reference: 2) Airaksinen, J., Ikaheimo, M, Kaila, J., Linnaluoto, M. and Takkunen, J.: Impaired left ventricular filling in young diabetics. Acta Med. Scand., 216, 509-516, 1984. – reference: 8) Kannel, W.B., Hjortland, M. and Castelli, W.P.: Role of diabetes in congestive heart failure; The Framingham study. Am. J. Cardiology, 34, 29-34, 1974. – reference: 13) Abenavoli, T., Rubler, S., Fisher, V.J., Axelrod, H.T. and Zuckerman, K.P.: Exercise testing with myocardial scintigraphy in asymptomatic diabetic males. Circulation, 63, 54-64, 1981. – reference: 9) Ahmed, S.S., Jaferi, G.A, Narang, R.M, and Regan, T.J.: Preclinical abnomalitiy of left ventricular function in diabetes mellitus. Am. Heart. J., 89, 153-158, 1975. – reference: 12) Shapiro, L.M., Howat, A.P. and Calter, M.M.: Left ventriclar function in diabetes mellitus I; Methodology and prevalence and spectrum of abnormalities. Br. Heart J., 45, 122-128, 1981. – reference: 14) Goldweit, R.S., Borer, J.S., Jovanovic, L.G., Drexler, A.J., Hochreiter, C.A., Devereux, R.B. and Peterson, C.M.: Relation of hemoglobin Al and blood glucose to cardiac function in diabetes mellitus. Am. J. Cardiology 56, 642-646, 1985. – reference: 15) 斎木茂樹: 若年者糖尿病患者における心機能異常; 自律神経抑制および運動負荷の影響. Jpn. Circ. J., 42, 1359-1371, 1978. – reference: 6) 鯵坂隆一, 飯田要, 松本龍馬, 藤田亮宣, 飯田啓治, 杉下靖郎, 伊藤巌, 武田徹, 畠山六郎, 外山比南子, 秋貞雅祥: イソプロテレノ一ル負荷心プールシンチグラフィーによる虚血性心疾患の左心機能評価. 心臓, 18, 255-231, 1986. – reference: 4) 成田充啓, 栗原正, 村野謙一, 宇佐美暢久, 本田稔, 金尾啓右: 肥大心における拡張期指標の有用性; 99mTC心プールイメージングによる検討. 核医, 29, 1133-1144, 1983. – reference: 10) Senevirante, B.I.B.: Diabetic cardiomyopathy; The preclinical phase. Br. Med. J., 1, 1444-1446, 1977. – reference: 3) Hamby, L., Zoneraich, S. and Sherman, L.: Diabetic cardiomyopathy. J. Am, Med. Assoc., 229, 1749-1754, 1974. – reference: 1) Shapira, L.: A prospective study of heart disease in diabetes mellitus. Quart. J. Med., 209, 55-68, 1984. – reference: 5) 大森好晃, 加納康至, 塩谷英之, 藤谷和大, 福崎恒, 梶谷定志, 中島義治, 前田和美: 運動負荷心ブールシンチグラフィによる虚血性心疾患の左心機能評価. 心臓, 17, 112-117, 1985. |
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| SubjectTerms | cardiac function diabetes mellitus dynamic exercise test radionuclide ventriculography |
| Title | Radionuclide ventriculographic evaluation of exercised leftventricular performance in asymptomatic diabetic patients |
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