Progression of functional and structural cardiac alterations in young normotensive uncomplicated patients with type 1 diabetes mellitus

Carugo, Stefano; Giannattasio, Cristina; Calchera, Ivan; Paleari, F.; Gorgoglione, Maria Grazia; Grappiolo, Alessandra; Gamba, Pierluigi; Rovaris, Giovanni; Failla, Monica; Mancia, Giuseppe

doi:10.1097/00004872-200109000-00021

Cited by 44 publications

(27 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Both serum cholesterol and glycemic control predicted higher systolic BP in our study. Abdelghaffar et al and Carugo et al have reported a similar difference in blood pressures of diabetics versus controls in their studies [32, 33]. However, Aepfelbacher et al did not document any difference in BP of T1DM even after a documented improvement in HbA1C [34].…”

Section: Discussionmentioning

confidence: 94%

Lipid Profile and Correlation to Cardiac Risk Factors and Cardiovascular Function in Type 1 Adolescent Diabetics from a Developing Country

Dabas

Yadav

Gupta

2014

International Journal of Pediatrics

View full text Add to dashboard Cite

Objective. The adverse role of dyslipidemia in predicting cardiovascular outcomes has not been elucidated extensively among type 1 diabetics in the literature. Methods. We assessed dyslipidemia and its correlation to other cardiac risk factors in adolescents with type 1 diabetes. Total thirty type 1 adolescent diabetics were evaluated for their metabolic profile, including serum lipids and echocardiography was performed. Results. The average age of the cohort was 14.3 ± 3.09 yr with disease duration of 5.35 ± 2.94 yr. The mean HbA1C was 8.01%. The mean serum cholesterol, LDL, HDL, and triglyceride were normal. Serum cholesterol was high in patients with longer disease duration (P = 0.011, r = 0.41), high systolic blood pressure (P = 0.04, r = 0.32), and elevated HbA1C > 8% (P = 0.038, r = 0.33). Higher lipid values were associated with poorer carotid artery distensibility (P > 0.05) and higher carotid artery intimomedial thickness (cIMT) (P < 0.05 for cholesterol and LDL). Hyperglycemia adversely affected ejection fractions, though serum lipids did not show any significant effect on left ventricular parameters. Conclusions. Dyslipidemia and hyperglycemia can serve as biomarkers for cardiovascular dysfunction in at-risk adolescents with type 1 diabetes. Carotid artery parameters are adjunctive tools which may be affected early in the course of macrovascular disease.

show abstract

Section: Discussionmentioning

confidence: 94%

Lipid Profile and Correlation to Cardiac Risk Factors and Cardiovascular Function in Type 1 Adolescent Diabetics from a Developing Country

Dabas

Yadav

Gupta

2014

International Journal of Pediatrics

View full text Add to dashboard Cite

show abstract

“…19,20 Indeed, echocardiography performed in 87 patients with type 1 diabetes mellitus without known coronary artery disease revealed diastolic dysfunction with a reduction in early diastolic filling, an increase in atrial filling, an extension of isovolumetric relaxation, and increased numbers of supraventricular premature beats. 21 In similar subjects with uncomplicated type 1 diabetes without clinically apparent macrovascular or microvascular complications, Carugo et al 22 reported early structural and functional cardiac alterations such as increased LV wall thickness and LV mass index, an age-related decline in ejection fraction, and an age-related increase in diastolic diameter. Similar approaches in well-controlled subjects with type 2 diabetes have revealed a prevalence of diastolic dysfunction of up to 30%.…”

Section: Human Studiesmentioning

confidence: 99%

Diabetic Cardiomyopathy Revisited

2007

View full text Add to dashboard Cite

Abstract-Diabetes mellitus increases the risk of heart failure independently of underlying coronary artery disease, and many believe that diabetes leads to cardiomyopathy. The underlying pathogenesis is partially understood. Several factors may contribute to the development of cardiac dysfunction in the absence of coronary artery disease in diabetes mellitus. This review discusses the latest findings in diabetic humans and in animal models and reviews emerging new mechanisms that may be involved in the development and progression of cardiac dysfunction in diabetes. (Circulation. 2007;115:3213-3223.)Key Words: diabetes mellitus Ⅲ fatty acids Ⅲ heart failure Ⅲ metabolism Ⅲ obesity T he prevalence of diabetes mellitus is growing rapidly. It is estimated that globally the number of adults affected with diabetes will increase from 135 million in 1995 to 300 million by 2025. 1 Patients with diabetes mellitus are at increased risk for cardiovascular diseases. Thus, cardiovascular complications are the leading cause of diabetes-related morbidity and mortality. 2 Diabetes mellitus is responsible for diverse cardiovascular complications such as increased atherosclerosis in large arteries (carotids, aorta, and femoral arteries) and increased coronary atherosclerosis, which increases the risk for myocardial infarction, stroke, and limb loss. Microangiopathy contributes to retinopathy and renal failure and may contribute to cardiac pathology as well. 3,4 Diabetes mellitus also can affect cardiac structure and function in the absence of changes in blood pressure and coronary artery disease, a condition called diabetic cardiomyopathy. This term was introduced 30 years ago by Rubler et al, 5 who described 4 diabetic patients with congestive heart failure and normal coronary arteries. Since then, diabetic cardiomyopathy has been defined as ventricular dysfunction that occurs independently of coronary artery disease and hypertension. In addition, diabetic cardiomyopathy may be characterized by diastolic dysfunction, which becomes more apparent in the presence of hypertension or myocardial ischemia (discussed in detail in the next section). Human StudiesMany epidemiological and clinical studies have suggested the existence of a diabetic cardiomyopathy in humans. 2,6 -9 Diabetes mellitus is a well-recognized risk factor for developing heart failure. Indeed, the Framingham Heart Study showed that the frequency of heart failure is twice in diabetic men and five times in diabetic women compared with age-matched control subjects. 10 This increased incidence of heart failure in diabetic patients persisted despite correction for age, hypertension, obesity, hypercholesterolemia, and coronary artery disease. Studies using independent population databases have provided similar results, revealing increased heart failure rates in subjects with diabetes mellitus in cross-sectional analyses and increased risk for developing heart failure in prospective analyses, even after correction for confounding variables. [11][12][13] Echocardiographic c...

show abstract

“…Likewise, a long-term prospective study of T1DM found no significant changes to myocardium structure suggesting that diabetes may not have direct effects on the heart ( Genuth, et al, 2013;Litwin, 2013). However, various human and animal studies have shown the development of diastolic dysfunction alongside structural changes to the myocardium ( Carugo, et al, 2001;Joffe, et al, 1999;Pacher, et al, 2002;Schannwell, Schneppenheim, Perings, Plehn, & Strauer, 2002;Shivalkar, et al, 2006). In contrast, T2DM strongly is associated with HF (de Simone, et al, 2010).…”

Section: Is Diabetic Cardiomyopathy a Distinct Phenotype?mentioning

confidence: 99%

Targeting caveolin-3 for the treatment of diabetic cardiomyopathy

Murfitt

Whiteley

Iqbal

et al. 2015

Pharmacology & Therapeutics

View full text Add to dashboard Cite

Progression of functional and structural cardiac alterations in young normotensive uncomplicated patients with type 1 diabetes mellitus

Abstract: Uncomplicated type I diabetes mellitus is characterized by early structural and functional cardiac alterations. Some of these alterations show a measurable progression within a relatively short time span.

Cited by 44 publications

References 40 publications

Lipid Profile and Correlation to Cardiac Risk Factors and Cardiovascular Function in Type 1 Adolescent Diabetics from a Developing Country

Lipid Profile and Correlation to Cardiac Risk Factors and Cardiovascular Function in Type 1 Adolescent Diabetics from a Developing Country

Diabetic Cardiomyopathy Revisited

Targeting caveolin-3 for the treatment of diabetic cardiomyopathy

Contact Info

Product

Resources

About