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

A tissue Doppler echocardiographic study

¹ Department of Cardiovascular Medicine, University of Oxford, Oxford, U.K
² First Cardiology Department, AHEPA University Hospital, Thessaloniki, Greece
³ First Propedeutic Department of Internal Medicine, Internal Medicine, AHEPA University Hospital, Thessaloniki, Greece

Address correspondence and reprint requests to Dr. Theodoros D. Karamitsos, Cardiovascular Medicine, University of Oxford, Oxford, U.K., OX3 9DU. E-mail: theo.karamitsos{at}cardiov.ox.ac.uk

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.

Abbreviations: ANF, autonomic nervous function • CAN, cardiovascular autonomic neuropathy • LV, left ventricular • TDI, tissue Doppler imaging

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				T. D. Karamitsos, H. I. Karvounis, T. Didangelos, G. E. Parcharidis, and D. T. Karamitsos Impact of Autonomic Neuropathy on Left Ventricular Function in Normotensive Type 1 Diabetic Patients: a Tissue Doppler Echocardiographic Study: Response to Humpert et al. Diabetes Care, May 1, 2008; 31(5): e41 - e41. [Full Text] [PDF]