Impact of Autonomic Neuropathy on Left Ventricular Function in Normotensive Type 1 Diabetic Patients: a Tissue Doppler Echocardiographic Study
Response to Karamitsos et al.
- Per M. Humpert, MD1,
- Dimitrios Oikonomou, MD1,
- Michael Morcos, MD1,
- Helmut Kuecherer, MD2,
- Tobias Schilling, MD1,
- Angelika Bierhaus, PHD1,
- Peter P. Nawroth, MD1,
- Hugo A. Katus, MD2 and
- Grigorios Korosoglou, MD2
- 1Department of Medicine I and Clinical Chemistry, Heidelberg University, Heidelberg, Germany
- 2Department of Medicine III, Heidelberg University, Heidelberg, Germany
- Corresponding author: Dr. Per Humpert, Dept. of Medicine I, Heidelberg University, INF410, 69123 Heidelberg, Germany. E-mail: per.humpert{at}med.uni-heidelberg.de
Data from a recent study (1) suggest that autonomic cardiovascular function (ANF) influences left ventricular (LV) diastolic function in patients with type 1 diabetes. Utilizing similar methods, including tissue Doppler imaging (TDI) and echocardiographic phase imaging (EPI) as described (2), we studied 49 type 2 diabetic patients (33 men, 16 women) with normal renal function and LV wall thickness. Five patients had a history of coronary artery disease (CAD), and none had previous myocardial infarction. Patients were screened for ANF as described (3) utilizing a standardized protocol and were divided into groups by tertiles of expiration-to-inspiration ratio (E/I) of heart rate variability (4 …
