Japanese
English
- 有料閲覧
- Abstract 文献概要
- 1ページ目 Look Inside
糖尿病における心病変は,microangiopathyとしての冠動脈硬化症と考えられていたが,Rublerら1)の報告以来,冠動脈病変によらない心筋障害が生じることが示され注目され始めた。その成因としてmicroangiopathyを主因に,心筋代謝,自律神経障害などの要因が考えられているが,いまなお不明な点が多い。臨床的特徴としてKannelら2)は糖尿病患者にうっ血性心不全の頻度が高く,冠動脈硬化症,高血圧症などの因子を除外してもなお高いと報告し,糖尿病による心筋障害が関与していると考えた。最近では,心機能検査による検討で,臨床的に明らかな心病変の無い時期に既に心機能低下の見られることが認められ,種々の方法による研究がされている。
著者らも糖尿病患者の心機能を心機図,心エコー図により評価し,どのような症例に心機能障害が見られるかについて検討した。
We measured cardiac functions by means of me-chanocardiogram and echo-cardiogram in 93 patients with diabetes mellitus, excluding those who had ap-parent cardiac diseases, such as angina pectoris and cardiac failure.
We used pre-ejection-period/ejection time (PEP/ ET) as the index of the left ventricular systolic funct-ion and isovolumic relaxation time (IRT) as that of the left ventricular diastolic function.
We compared the diabetic cases without complica-tions to those with complications such as retinopathy, nephropathy, neuropathy and autonomic disorder. Conclusions obtained were as follows ;
An abnormal IRT was noted in the early stage of diabetic complications. The IRT was not normal among the subjects even when those with cardiac hypertrophy or ST-depression on the ECG were excluded.
On the contrary, the PEP/ET did not show any abnormality in the early stage of diabetic complica-tions until they advanced into, eg. renal failure or severe neuropathy.
Our findings suggest that the disorder of the left ventricular diastolic function precedes that of the left ventricular systolic function, indicating the associa-tion of microangiopathy and autonomic disorder.
Copyright © 1989, Igaku-Shoin Ltd. All rights reserved.