Impact of Diabetes on the Left Ventricular Long Axis and Midwall Function in Patients with Hypertension

Diabetes mellitus (DM) is a strong risk factor for cardiovascular morbidity and mortality. It is suggested that both hypertension and DM may synergistically affect left ventricular (LV) structure and function. To assess whether hypertensive patients with DM have more depressed LV function in terms of long axis and midwall function by use of tissue Doppler echocardiogram than do patients with hypertension only. Hypertensive patients (n=200) and hypertensive patients with DM (n=60), all of whom had normal LV ejection fraction, were recruited for the study. Healthy age- and sex-matched subjects (n=20) served as the control group. Echocardiography was performed including LV wall thickness, dimension, Doppler, and tissue Doppler imaging. Blood pressure (BP) was measured in the supine position before and after echocardiographic examination. The hypertensive patients with or without DM had higher BP and LV wall thickness, had more decreased afterload measured by meridional end-systolic stress, and had more depressed LV diastolic, long axis, and global function than did the controls. There was no difference in LV function between the hypertensive patients with and without DM. The hypertensive patients with or without DM had depressed LV function compared with the controls, but there was no difference between the hypertensive patients with or without DM. DM does not seem to have additive adverse effects on the LV long axis and midwall function in persons with hypertension.