Impact of Autonomic Neuropathy on Left Ventricular Function in Normotensive Type 1 Diabetic Patients

Abstract

Cardiovascular autonomic neuropathy (CAN) is one of the most serious complications of diabetes and has been weakly linked with left ventricular (LV) diastolic dysfunction. Previous studies that explored this association either suffer from inadequate definition of CAN or have mainly used conventional Doppler or nuclear techniques to investigate LV diastolic function. Tissue Doppler imaging (TDI) has evolved as a new quantitative tool for the assessment of cardiac systolic function, diastolic function, and the hemodynamics of LV filling. We sought to investigate conventional and TDI-derived indexes of LV systolic and diastolic function in type 1 diabetic patients with and without CAN and also in normal control subjects. Our findings suggest that the presence of CAN seems to have an additive effect on LV diastolic dysfunction in type 1 diabetes.

Left ventricular function and energy homeostasis in patients with type 1 diabetes with and without microvascular complications

“…Interpretation of our data should also take into consideration two important pathogenic factors associated with overt microvascular complications: the autonomic neuropathy [28,29] and the advanced glycation end products (AGE) [30]. Therefore it is possible that the abnormal LV function and metabolism observed in the subgroup of patients with overt microvascular complications could be mediated by these important factors.…”

The Valsalva Maneuver Can Misdiagnose ‘Normal' as ‘Pseudonormal': A Word of Caution for an Echocardiographic Evaluation of Diastolic Function

“…Although DTI-derived parameters are known to be less dependent on preload and/or afterload, they are not absolutely independent of changes in heart-loading conditions. (2) Doppler-derived echocardiographic parameters, including E' and S', can be affected by cardiac autonomic function [13,18,19]. Because the Valsalva maneuver can influence cardiac autonomic function [14,15,20], it might be, at least in part, associated with the distinct features of changes in diastolic functional parameters of the maneuver compared to those of NTG.…”

The influence of diabetic autonomous neuropathy on myocardial remodeling in type 1 diabetes mellitus

“…При этом, признавая значимую роль артериальной гипертензии в развитии ГЛЖ при СД, некоторые авторы сообщают о случаях структурных нарушений миокарда, не связанных с гипертонией, ишемией миокарда, клапанными нарушениями [12][13][14].…”