PMID- 21502332
OWN - NLM
STAT- MEDLINE
DCOM- 20110929
LR  - 20220318
IS  - 1942-0080 (Electronic)
IS  - 1941-9651 (Linking)
VI  - 4
IP  - 4
DP  - 2011 Jul
TI  - Relationship between early diastolic dysfunction and abnormal microvolt T-wave 
      alternans in patients with type 2 diabetes.
PG  - 408-14
LID - 10.1161/CIRCIMAGING.110.962951 [doi]
AB  - BACKGROUND: Abnormal microvolt T-wave alternans (MTWA), a marker of ventricular 
      arrhythmic risk, is a highly prevalent condition in patients with type 2 diabetes 
      mellitus (T2DM) and is correlated with glycemic control. However, there is 
      uncertainty as to whether central or peripheral hemodynamic factors are 
      associated with abnormal MTWA in T2DM individuals. METHODS AND RESULTS: We 
      studied 50 consecutive, well-controlled T2DM outpatients without a history of 
      ischemic heart disease and with normal systolic function. All patients underwent 
      a complete echocardiographic Doppler evaluation with spectral tissue Doppler 
      analysis. MTWA analysis was performed noninvasively during submaximal exercise. 
      Effective arterial elastance, arterial compliance, and heart rate variability 
      were also measured. Compared with patients with MTWA negativity (n = 38), those 
      with MTWA abnormality (n = 12, 24%) had significantly lower e' (7.6 +/- 1.3 versus 
      9.1 +/- 1.7 cm/s; P < 0.01), a' (10.2 +/- 1.6 versus 12.7 +/- 1.9 cm/s; P < 0.001) and 
      s' velocities (8.7 +/- 1.1 versus 10.2 +/- 1.5 cm/s; P = 0.001) and higher indexed 
      left ventricular mass (121.3 +/- 16.4 versus 107.5 +/- 16.5 g/m2; P = 0.016), indexed 
      left atrial volume (33.5 +/- 11.9 versus 23.6 +/- 5.6 mL/m2; P < 0.001), and E/e' 
      ratio (8.8 +/- 1.4 versus 6.5 +/- 1.3; P < 0.001). Multivariable logistic regression 
      analysis revealed that higher E/e' ratio was the only independent correlate of 
      abnormal MTWA (adjusted odds ratio, 3.52; 95% confidence interval, 1.19 to 10.6; 
      P = 0.02) after controlling for glycemic control and other potential confounders. 
      CONCLUSIONS: In this pilot study, we found that early diastolic dysfunction, as 
      measured by tissue Doppler imaging, is independently associated with MTWA 
      abnormality in T2DM individuals with normal systolic function. Further larger 
      studies are needed to examine the reproducibility of these results.
FAU - Bonapace, Stefano
AU  - Bonapace S
AD  - Division of Cardiology, Sacro Cuore Hospital, Italy.
FAU - Targher, Giovanni
AU  - Targher G
FAU - Molon, Giulio
AU  - Molon G
FAU - Rossi, Andrea
AU  - Rossi A
FAU - Costa, Alessandro
AU  - Costa A
FAU - Zenari, Luciano
AU  - Zenari L
FAU - Bertolini, Lorenzo
AU  - Bertolini L
FAU - Cian, Debora
AU  - Cian D
FAU - Lanzoni, Laura
AU  - Lanzoni L
FAU - Barbieri, Enrico
AU  - Barbieri E
LA  - eng
PT  - Journal Article
DEP - 20110418
PL  - United States
TA  - Circ Cardiovasc Imaging
JT  - Circulation. Cardiovascular imaging
JID - 101479935
SB  - IM
MH  - Aged
MH  - Arrhythmias, Cardiac/*diagnostic imaging/*etiology/physiopathology
MH  - Chi-Square Distribution
MH  - Diabetes Mellitus, Type 2/*complications/physiopathology
MH  - Diastole/physiology
MH  - *Echocardiography, Doppler
MH  - Female
MH  - Heart Function Tests
MH  - Heart Rate/physiology
MH  - Humans
MH  - Logistic Models
MH  - Male
MH  - Pilot Projects
MH  - Regression Analysis
MH  - Risk Assessment
MH  - Statistics, Nonparametric
MH  - Systole/physiology
MH  - Vascular Resistance/physiology
EDAT- 2011/04/20 06:00
MHDA- 2011/10/01 06:00
CRDT- 2011/04/20 06:00
PHST- 2011/04/20 06:00 [entrez]
PHST- 2011/04/20 06:00 [pubmed]
PHST- 2011/10/01 06:00 [medline]
AID - CIRCIMAGING.110.962951 [pii]
AID - 10.1161/CIRCIMAGING.110.962951 [doi]
PST - ppublish
SO  - Circ Cardiovasc Imaging. 2011 Jul;4(4):408-14. doi: 
      10.1161/CIRCIMAGING.110.962951. Epub 2011 Apr 18.