Document Detail


Effects of blood pressure lowering and metabolic control on systolic left ventricular function in Type II diabetes mellitus.
MedLine Citation:
PMID:  16512787     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Decreased left ventricular long-axis function may be the earliest stage in subclinical heart failure in Type II diabetes. To assess whether a decrease in SBP (systolic blood pressure) or a change in metabolic control would improve the long-axis function, 48 Type II diabetic patients participating in the CALM II (Candesartan and Lisinopril Microalbuminuria II) study were included in the present study. Patients were examined with tissue Doppler echocardiography at baseline and after 3 and 12 months of follow-up. Corresponding blood pressure, fructosamine and HbA(1c) (glycated haemoglobin) values were obtained. During the follow-up period, a decrease in SBP of 8 mmHg was seen (from 141+/-11 mmHg at baseline to 133+/-12 mmHg; P<0.001) and the peak systolic strain rate was significantly improved (from -1.10+/-0.25 at baseline to -1.25+/-0.22; P<0.01). There was a highly significant relationship between the changes in systolic strain rate, HbA(1c) (P<0.001) and fructosamine (P<0.05), and similarly to changes in left ventricular mass (P<0.05), whereas the correlation to the SBP reduction was not significant. Patients with improved glycaemic control, defined as a reduced HbA(1c) value after 12 months of follow-up, had a significantly improved strain rate (from -1.07+/-0.3 s(-1) at baseline to -1.32+/-0.25 s(-1); P<0.01) compared with patients with increases in HbA(1c) (from -1.14+/-0.25 s(-1) at baseline to -1.16+/-0.27 s(-1); P=not significant). The two groups had comparable baseline values of SBP, left ventricular mass, age and disease duration. In conclusion, changes in left ventricular systolic long-axis function are significantly correlated with changes in left ventricular mass, as well as metabolic control, in hypertensive patients with Type II diabetes mellitus.
Authors:
Niels H Andersen; Steen H Poulsen; Per L Poulsen; Søren T Knudsen; Kjeld Helleberg; Klavs W Hansen; Dines S Dinesen; Hans Eiskjaer; Allan Flyvbjerg; Carl E Mogensen
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical science (London, England : 1979)     Volume:  111     ISSN:  0143-5221     ISO Abbreviation:  Clin. Sci.     Publication Date:  2006 Jul 
Date Detail:
Created Date:  2006-06-12     Completed Date:  2006-08-18     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7905731     Medline TA:  Clin Sci (Lond)     Country:  England    
Other Details:
Languages:  eng     Pagination:  53-9     Citation Subset:  IM    
Affiliation:
Medical Department M (Diabetes and Endocrinology) and The Medical Research Laboratories, Aarhus University Hospital, DK-8000 Aarhus C, Denmark. holmark@ki.au.dk
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MeSH Terms
Descriptor/Qualifier:
Aged
Antihypertensive Agents / therapeutic use
Blood Glucose / metabolism
Diabetes Mellitus, Type 2 / blood,  physiopathology*
Diabetic Angiopathies / blood,  drug therapy,  physiopathology*
Echocardiography, Doppler
Female
Follow-Up Studies
Fructosamine / blood
Heart Ventricles / pathology
Hemoglobin A, Glycosylated / metabolism
Humans
Hypertension / blood,  drug therapy*,  physiopathology
Male
Middle Aged
Organ Size
Ventricular Dysfunction, Left / blood,  physiopathology*,  ultrasonography
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 0/Blood Glucose; 0/Hemoglobin A, Glycosylated; 4429-04-3/Fructosamine

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