Patients with early diabetic heart disease demonstrate a normal myocardial response to dobutamine

Fang, Z. Y., Najos-Valencia, O, Leano, R. L. and Marwick, T. H. (2003) Patients with early diabetic heart disease demonstrate a normal myocardial response to dobutamine. Journal of the American College of Cardiology, 42 3: 446-453. doi:10.1016/S0735-1097(03)00654-5

Author Fang, Z. Y.
Najos-Valencia, O
Leano, R. L.
Marwick, T. H.
Title Patients with early diabetic heart disease demonstrate a normal myocardial response to dobutamine
Journal name Journal of the American College of Cardiology   Check publisher's open access policy
ISSN 0735-1097
Publication date 2003-01-01
Sub-type Article (original research)
DOI 10.1016/S0735-1097(03)00654-5
Open Access Status Not yet assessed
Volume 42
Issue 3
Start page 446
End page 453
Total pages 8
Editor Dr William W Parmley
Place of publication New York
Publisher Elsevier Science
Language eng
Subject C1
321003 Cardiology (incl. Cardiovascular Diseases)
730106 Cardiovascular system and diseases
Abstract OBJECTIVES We sought to use quantitative markers of the regional left ventricular (LV) response to stress to infer whether diabetic cardiomyopathy is associated with ischemia. BACKGROUND Diabetic cardiomyopathy has been identified in clinical and experimental studies, but its cause remains unclear. METHODS We studied 41 diabetic patients with normal resting LV function and a normal dobutamine echo and 41 control subjects with a low probability of coronary disease. Peak myocardial systolic velocity (Sm) and early diastolic velocity (Em) in each segment were averaged, and mean Sm and Em were compared between diabetic patients and controls and among different stages of dobutamine stress. RESULTS Both Sm and Em progressively increased from rest to peak dobutamine stress. In the diabetic group, Sm was significantly lower than in control subjects at baseline (4.2 +/- 0.9 cm/s vs. 4.7 +/- 0.9 cm/s, p = 0.012). However, Sin at a low dose (6.0 +/- 1.3), before peak (8.4 +/- 1.8), and at peak stress (8.9 +/- 1.8) in diabetic patients was not significantly different from that of controls (6.3 +/- 1.4, 8.9 +/- 1.6, and 9.6 +/- 2.1 cm/s, respectively). The Em (cm/s) in the diabetic group (rest: 4.2 +/- 1.2; low dose: 5.0 +/- 1.4; pre-peak: 5.3 +/- 1.1; peak: 5.9 +/- 1.5) was significantly lower than that of controls (rest: 5.8 +/- 1.5; low dose: 6.6 +/- 1.5; pre-peak: 6.9 +/- 1.3; peak: 7.3 +/- 1.7; all p < 0.001). However, the absolute and relative increases in Sm or Em from rest to peak stress were similar in diabetic and control groups. CONCLUSIONS Subtle LV dysfunction is present in diabetic patients without overt cardiac disease. The normal response to stress suggests that ischemia due to small-vessel disease may not be important in early diabetic heart muscle disease. (C) 2003 by the American College of Cardiology Foundation.
Keyword Cardiac & Cardiovascular Systems
Left-ventricular Hypertrophy
Stress Echocardiography
Q-Index Code C1
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
2004 Higher Education Research Data Collection
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 75 times in Thomson Reuters Web of Science Article | Citations
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Created: Wed, 15 Aug 2007, 11:37:41 EST