Sixty patients with non-insulin-dependent diabetes underwent M-mode echocardiographic examination. They were all in good metabolic control under treatment with oral antidiabetic drugs and/or diet; none had clinical evidence of micro- or macroangiopathy, cardiovascular disease, arterial hypertension, or other associated risk factors. The control group consisted of 30 normal subjects. No significant differences were shown either with routine or computer-assisted evaluation of the echocardiograms; if there was a significant difference, there was a wide overlap with normal values. However, alterations of the systolic function of the left ventricle were shown by the reduction of the percentage fractional shortening during the first third of systole (9.14 +/- 5.85 vs 12.27 +/- 7.04, p less than 0.05); alterations of the diastolic function were shown by the marked mitral opening delay (54.15 +/- 20.64 msec vs 10.57 +/- 5.18, p less than 0.00001) and the presence of a B notch (50% of the diabetics). In particular, the B notch seemed to be associated with more severe impairment of left ventricular performance. Therefore, these data appear particularly useful in detecting even slight abnormalities in cardiac function in diabetic patients.

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Vectorcardiographic evaluation of diabetic cardiomyopathy and of its contributing factors.

In order to investigate the prevalence of vectorcardiographic bites, expression of small areas of fibrosis, atrophy or degeneration of the myocardium, we studied, using the vectorcardiograms (VCG) of 101 diabetic patients (35 with insulin-dependent and 66 with non-insulin-dependent diabetes mellitus, aged from 25 to 60 years, without hypertension, coronary artery disease, or intraventricular conduction defects) and 228 normal control subjects, matched for age and sex. The prevalence of bites was 38.6% in diabetic patients and 10.0% in the control group (p less than 0.001). Diabetic patients were also subdivided into groups according to age, sex, metabolic control, risk factors for coronary heart disease, type of diabetes, duration of diabetes and diabetic microangiopathy. No correlation was found between any of the variables investigated nor of a combination of these, and the presence of bites. We conclude that VCG is a sensitive test for cardiac involvement in diabetic patients but that it cannot be used to identify any specific factor able to influence the onset and evolution of this involvement.

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