Influence of autonomic neuropathy upon left ventricular dysfunction in insulin-dependent diabetic patients

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dc.contributor.authorMonteagudo, Patrícia Teófilo [UNIFESP]
dc.contributor.authorMoisés, Valdir Ambrósio [UNIFESP]
dc.contributor.authorKohlmann Junior, Osvaldo [UNIFESP]
dc.contributor.authorRibeiro, Artur Beltrame [UNIFESP]
dc.contributor.authorLima, Valter Correia de [UNIFESP]
dc.contributor.authorZanella, Maria Teresa [UNIFESP]
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.date.accessioned2018-06-15T16:52:46Z
dc.date.available2018-06-15T16:52:46Z
dc.date.issued2000-05-01
dc.description.abstractBackground: Diabetic cardiomyopathy is a well-defined complication of diabetes that occurs in the absence of ischemic, vascular, and hypertensive disease.Hypothesis: The study was undertaken to test the relationship among autonomic neuropathy (AN), 24-h blood pressure (BP) profile, and left ventricular function.Methods: Nineteen type-1 diabetic patients underwent autonomic tests and echocardiographic examination. Patients were divided according to the presence (AN+) or absence (AN-) of AN.Results: In the AN+ group (n = 8), the E/A ratio at echo was lower than in the AN- group (n = 11) (1.1 +/- 0.3 vs. 1.6 +/- 0.3; p < 0.005). Systolic and diastolic BP reductions during sleep were smaller in the AN+ than in the AN- group (6.6 +/- 6.6 vs. 13.0 +/- 4.3%; p < 0.03 for systolic and 12.8 +/- 6.8 vs. 20.0 +/- 4.0% for diastolic BP reduction; p < 0.03, respectively). Considering all patients, the EIA ratio correlated inversely with awake diastolic BP (r - 0.63; p = 0.005); sleep systolic BP (r - 0.48; p = 0.04), and sleep diastolic BP (r - 0.67; p = 0.002). The AN correlated with diastolic interventricular septum thickness (r 0.57; p = 0.01), sleep systolic BP (r 0.45; = 0.05), sleep diastolic BP (r 0.54; p = 0.02), and correlated inversely with systolic and diastolic sleep BP reduction (r - 0.49; p = 0.03 and r - 0.67; p = 0.002, respectively). Finally, E/A ratio and AN score correlated between themselves (r - 0.6; p = 0.005).Conclusion: Our results suggest that left ventricular diastolic dysfunction may be detected very early in type-1 diabetic patients with AN. Parasympathetic lesion and nocturnal elevations in BP could be the Link between AN and diastolic ventricular dysfunction.en
dc.description.affiliationUNIFESP, Escola Paulista Med, Dept Med, Div Endocrinol, BR-04024000 Sao Paulo, Brazil
dc.description.affiliationUNIFESP, Escola Paulista Med, Dept Med, Div Cardiol, BR-04024000 Sao Paulo, Brazil
dc.description.affiliationUNIFESP, Escola Paulista Med, Dept Med, Div Nephrol, BR-04024000 Sao Paulo, Brazil
dc.description.affiliationUnifespUNIFESP, Escola Paulista Med, Dept Med, Div Endocrinol, BR-04024000 Sao Paulo, Brazil
dc.description.affiliationUnifespUNIFESP, Escola Paulista Med, Dept Med, Div Cardiol, BR-04024000 Sao Paulo, Brazil
dc.description.affiliationUnifespUNIFESP, Escola Paulista Med, Dept Med, Div Nephrol, BR-04024000 Sao Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent371-375
dc.identifierhttp://dx.doi.org/10.1002/clc.4960230513
dc.identifier.citationClinical Cardiology. Mahwah: Clinical Cardiology Publ Co, v. 23, n. 5, p. 371-375, 2000.
dc.identifier.doi10.1002/clc.4960230513
dc.identifier.issn0160-9289
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/43351
dc.identifier.wosWOS:000086771200011
dc.language.isoeng
dc.publisherClinical Cardiology Publ Co
dc.relation.ispartofClinical Cardiology
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectdiabetic cardiomyopathyen
dc.subjectautonomic neuropathyen
dc.subjectleft diastolic dysfunctionen
dc.subjecttype-1 diabetesen
dc.subjectinsulin-dependent diabetesen
dc.titleInfluence of autonomic neuropathy upon left ventricular dysfunction in insulin-dependent diabetic patientsen
dc.typeinfo:eu-repo/semantics/article
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