Document Detail

Advanced left ventricular diastolic dysfunction in uremic patients with type 2 diabetes on maintenance hemodialysis.
MedLine Citation:
PMID:  22786470     Owner:  NLM     Status:  MEDLINE    
BACKGROUND:  Diabetic nephropathy is the leading cause of end-stage renal disease (ESRD). Myocardial dysfunction may occur in patients with diabetes mellitus (DM) in the absence of coronary artery disease or left ventricular (LV) hypertrophy. Although tissue Doppler imaging (TDI) is a highly effective means of quantifying myocardial diastolic function, its differences in ESRD patients with diabetes and without diabetes remain unclear.
METHODS AND RESULTS:  A total of 101 ESRD patients on maintenance hemodialysis with normal LV systolic function were studied: 37 with type 2 DM and 64 without DM. Conventional echocardiography and TDI were performed to evaluate LV systolic and diastolic functions. The conventional LV systolic and diastolic echocardiographic parameters did not differ according to presence of DM, except for the left atrial size and volume index (P<0.001). The ESRD patients with DM, however, had significantly decreased mitral annular early diastolic peak velocity (e') and ratio of early to late diastolic mitral annular velocity (e'/a'; both P<0.02). Additionally, the group with DM had markedly higher estimated LV end-diastolic filling pressure (E/e'; P=0.011).
CONCLUSIONS:  ESRD patients with DM had advanced LV diastolic dysfunction on TDI. In ESRD patients with DM, diabetic cardiomyopathy associated with advanced LV diastolic dysfunction is observed.  (Circ J 2012; 76: 2380-2385).
Kuo-Chun Hung; Cheng-Hung Lee; Chun-Chi Chen; Chi-Ming Chu; Chao-Yung Wang; I-Chang Hsieh; Ji-Tseng Fang; Fen-Chiung Lin; Ming-Shien Wen
Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-07-07
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  76     ISSN:  1347-4820     ISO Abbreviation:  Circ. J.     Publication Date:  2012  
Date Detail:
Created Date:  2012-09-25     Completed Date:  2013-02-14     Revised Date:  2013-02-19    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  2380-5     Citation Subset:  IM    
Second Section of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 199 Tung Hwa North Road, Taipei, 105 Taiwan.
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MeSH Terms
Diabetes Mellitus, Type 2* / physiopathology,  therapy,  ultrasonography
Diabetic Nephropathies* / physiopathology,  therapy,  ultrasonography
Echocardiography, Doppler
Heart Atria / physiopathology,  ultrasonography
Kidney Failure, Chronic* / etiology,  physiopathology,  therapy
Middle Aged
Renal Dialysis*
Uremia* / etiology,  physiopathology,  therapy,  ultrasonography
Ventricular Dysfunction, Left* / etiology,  physiopathology,  therapy,  ultrasonography

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