Left ventricular diastolic dysfunction in IDDM patients is strongly associated with autonomic neuropathy, supporting the concept of diabetic cardiomyopathy as a distinct entity independent of microvascular complications.
Association in cross-sectional data should not change practice; supports diabetic cardiomyopathy hypothesis but requires prospective confirmation.
This study used noninvasive methods to assess disturbance in cardiovascular function in insulin-dependent diabetes mellitus (IDDM) patients. Cardiovascular function and the autonomic nervous system of 38 IDDM patients were assessed, and the presence or absence of left ventricular dysfunction was determined. Fifty-six percent of the patients were found to have autonomic neuropathy. Twelve percent had left ventricular diastolic dysfunction; none had left ventricular systolic dysfunction. Heart disease in IDDM patients was found to constitute a separate entity, termed diabetic cardiomyopathy. All IDDM patients with left ventricular diastolic dysfunction had evidence of autonomic neuropathy. However, there was no correlation with left ventricular systolic dysfunction. Also, there was no correlation between left ventricular dysfunction and microvascular complications of diabetes mellitus.
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Rajan et al. (2002) studied this question.
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