Document Detail


Effect of acute ketoacidosis on the myocardium in diabetes.
MedLine Citation:
PMID:  8615375     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Abnormalities of left ventricular function are often present in patients with diabetes who are in a stable metabolic state. To determine whether acute metabolic abnormalities may contribute to pathogenesis, patients with diabetes and ketoacidosis (Group 1) or hyperglycemia without ketosis (Group 2) were studied. They were assessed noninvasively for evidence of acute injury or dysfunction of the myocardium. Left ventricular function was assessed on admission and after clinical recovery. Myocardial enzyme release was examined during the acute phase. In Group 1, plasma glucose averaged 32 mM/L and carbon dioxide content 12.4 mEq/L. On echocardiography, the initial circumferential shortening velocity of 1.85 + 0.07 circumferences per second was significantly higher than the final circumferential shortening velocity of 1.31 + 01 (P < 0.005). The systolic time interval ratio, pre-ejection period/left ventricular ejection time, was significantly lower on the initial day compared with the second study. These data are consistent with enhanced ventricular performance. In group 2, plasma glucose averaged 29 mM/L, and carbon dioxide content was normal. The initial circumferential shortening velocity of 1. 1 circumferences per second and pre-ejection period/left ventricular ejection time ratio of 0.38 were normal and remained unchanged. There was no significant alteration of heart rate or arterial pressure in either group. In both groups, total serum lactate dehydrogenase and creatinine phosphokinase levels, as well as their cardiac isoenzymes, were within normal limits. Therefore, the initial increase of myocardial performance and subsequent restoration to normal, as well as the lack of cardiac enzyme increase in plasma, support the view that shortterm ketoacidosis does not contribute to the abnormalities of ventricular function in diabetes.
Authors:
A K George; A Shih; T J Regan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of the medical sciences     Volume:  311     ISSN:  0002-9629     ISO Abbreviation:  Am. J. Med. Sci.     Publication Date:  1996 Feb 
Date Detail:
Created Date:  1996-06-05     Completed Date:  1996-06-05     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370506     Medline TA:  Am J Med Sci     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  61-4     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, USA.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Diabetes Mellitus / metabolism*
Diabetic Ketoacidosis / physiopathology*
Electrocardiography
Female
Heart / physiopathology*
Humans
Male
Myocardial Contraction

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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