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Aims/Hypothesis: Early determination of myocardial manifestations of diabetes mellitus
is of major importance, since myocardial involvement considerably influences the prognosis
of diabetic patients. The aim of this study was to investigate whether young patients
with insulin-dependent diabetes mellitus and normal systolic left ventricular (LV)
function already show a diastolic LV dysfunction and an increased risk of arrhythmias.
Methods: Echocardiography was performed in 87 patients suffering from type I diabetes
mellitus, without known cardiac disease and in 87 controls. Patients with a known
manifest cardiac disease or a long-term diabetic syndrome were excluded. Morphological
parameters were determined using M-mode echocardiography. Doppler echocardiography
was used to evaluate parameters of LV diastolic function. The risk of arrhythmia was
assessed by means of electrocardiography, heart rate variability, and late potential
analysis. Results: The left atrial and ventricular dimensions and systolic functional
parameters of all patients were normal. A diastolic dysfunction with a reduction in
early diastolic filling, an increase in atrial filling, an extension of isovolumetric
relaxation and deceleration time was documented in diabetic patients, as well as an
increased number of supraventricular and ventricular premature beats. Conclusion:
Even young patients with diabetes mellitus suffer from a diastolic dysfunction while
systolic ventricular function is normal. Therefore, echocardiography with measurements
of diastolic functional parameters appears to be a sensitive method for evaluating
the manifestation and course of early diabetic cardiomyopathy.