학술대회 안내 사전등록 안내 초록등록 안내 초록등록/관리 숙박및교통 안내


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ǥ : ȣ - 490140   157 
Comparison of Cardiac Structure and Function in Diabetes Mellitus with and without Systemic Hypertension
Division of Cardiology, Maryknoll General Hospital, Busan, Korea
Kyoung Im Cho, Chun Kwan Lee, Suk Hun Kim, Jeong Myung Ahan, San Kim, Jeong Ho Park, Tae Ik Kim
Background: As hypertension and LVH frequently coexist with diabetes, we sought to compare myocardial function and structural changes in diabetic patients with or without hypertension with those in nondiabetic subjects with hypertension(essential hypertension), in order to identify the role of diabetes alone in relation to myocardial dysfunction. Methods: We studied 50 patients with essential hypertension(HTN, 20 men, 30 women, aged 59±12 years), 54 diabetes mellitus patients without hypertension(DM-HTN, 24 men, 30 women, aged 60±9 years) , 53 diabetes mellitus patients with hypertension(DM+HTN, 23 men, 30 women, aged 61±7 years), 49 normal subjects(22 men, 27 women, aged 56 ± 13 years). We used echocardiography comprising standard 2-dimensional and conventional Doppler imaging including assessment of the isovolumetric Doppler time intervals(IRT) for the estimation of Doppler-derives MPI. Left ventricular mass index (LVMI) and relative wall thickness (RWT) were calculated according to Devereux formula and Ganau formula respectively. Subjects were considered to have: normal geometry (NG) if both LVMI and RWT were normal (LVMI≤104g/m2 in female, LVMI≤116g/m2 in male, RWT≤0.43); concentric hypertrophy (CH) if both were elevated; eccentric hypertrophy (EH) if LVMI was elevated and RWT was normal; and concentric remodeling(CR) if LVMI was normal and RWT was elevated. Results: The MPI was significantly higher in essential hypertension and diabetes, especially diabetes with hypertension(p<0.001), compared to controls(HTN=0.48±0.13; DM-HTN=0.41±0.09; DM+HTN=0.53 ±0.11; control=0.31±0.11, p<0.05). LVMI and RWT were significantly higher in essential hypertension and diabetes, especially diabetes with hypertension (p<0.001), compared to controls(HTN=132.2±44.4 g/m2 and 0.45±0.11; DM-HTN=125.9±34.4 g/m2 and 0.44±0.07; DM+HTN=153.9±42.9 g/m2 and 0.48 ±0.07; control=108.9±22.2 g/m2 and 0.39±0.05, p<0.05). Conclusion: Our study demonstrated the early appearance of both left ventricular systolic and diastolic dysfunction and adverse geometric changes in diabetic patients at rest and the contributory effects of Diabetes to myocardial impairment and LV hypertrophy produced by hypertension.


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