sexta-feira, março 05, 2010
Disfunção diastólica e Perfusão
Left Ventricular Diastolic Function in Type 2 Diabetes Mellitus
Cardiovascular Imaging. 2010;3:24-31
Methods and Results— A prospective observational study of 305 patients with type 2 diabetes mellitus (diabetes duration, 4.5±5.3 years) referred consecutively to a diabetes clinic were screened for LV systolic and diastolic function by echocardiography. Vascular function was estimated using noninvasive estimation of pulse pressure, carotid arterial compliance, total arterial compliance, and valvulo-arterial impedance. The prevalences of LV diastolic dysfunction and left atrial (LA) volume index >32 mL/m2 were 40% and 32%, respectively. The prevalence of myocardial ischemia on myocardial perfusion scintigraphy was more frequent in patients with grade 2 diastolic dysfunction and LA volume index >32 mL/m2 compared with those having normal or grade 1 diastolic dysfunction (P=0.002) or LA volume index 32 mL/m2 (P<0.001), respectively. Predictors of grade 2 diastolic dysfunction and LA dilation were summed stress score on myocardial perfusion scintigraphy, total arterial compliance, and valvulo-arterial impedance, whereas pulse pressure and carotid arterial compliance were not, after adjusting for age, sex, and diabetes duration. On multivariable modeling, summed stress score (P<0.001) and valvulo-arterial impedance (P=0.027) remained predictors of grade 2 diastolic dysfunction, and only summed stress score (P<0.001) was a predictor of LA dilation.
Conclusions— Thus, our findings support that moderate or severe LV diastolic dysfunction and LA dilation in the early phase of T2DM is closely associated with intrinsic LV dysfunction.
Em pacientes diabéticos assintomáticos, a prevalência de Disfunção diastólica tipo II e aumento do volume atrial foi de 40% e 32%, respectivamente.
Os dois juntos, foram fortemente associados a alteração da perfusão miocárdica.
É para isso que serve o ecocardiograma.