Endocrine Abstracts

The aim: To reveal relation between altered left ventricular (LV) geometry (G) and contractile ability (CA) in nonbese type 2 diabetic (DM2) patients with mild hypertension (MH).

Materials and methods: BP at rest, 24-h ambulatory BP monitoring and echocardiography were investigated in 70 non-obese males, aged 25–50 yrs. They were divided into the following groups: Gr.1, n=15 – DM2 and normal BP, fasting C-peptide (C-p, ng/ml) 4.3±0.95, HbA_1c 10.5±0.75%; Gr.2, n=10 – DM2 and latent hypertension, ≤190/110 mmHg, fasting C-p 4.2±0.75, HbA_1c 11.2±0.95%; Gr.3, n=15 – DM2 with overt MH ≤190/110 mmHg, fasting C-p 3.95±1.1, HbA_1c 10.7±0.83. Gr.4, n=10 – nonDM pts with latent hypertension, C-p 2.1.±0.54, HbA_1c 4.5±1.1; Gr.5, n=10 – nonDM pts with MH, fasting C-p 1.95±0.62, HbA_1c 5.2±0.95%; Controls (CG), n=10 – healthy persons. Thyroid pathology was excluded in all cases. Using LVMI and RWT, LVG was divided into: normal (N) – LVMI<51 g/ht², RWT<0.44; concentric remodeling (CR) – LVMI<51 g/ht², RWT>0.44; eccentric LV hypertrophy (EH-LLVMI>51 g/ht², RWT<0.44), concentric LV hypertrophy- (CH) (LVMI>51 g/ht², RWT>0.44).

Results: Gr.1 shows EH with EDV 127.0±2.1 ml, EF 63.9±2.5%, FS 34.3±0.9%, that did not differ from CG, (P>0.05) Gr.2 and 3 pts. In addition EH shows tendency to worsening of diastolic (EDV =199.5±3.8 ml, 220.0±4.5 ml respectively, P<0.01) and systolic functions (FS 28.0±0.9%), EF 53.3 P<0.05). Gr.4 pts had CR accompanied with significant (as compared to CG, P<0.01) increase in EDV 210.0±2.4 ml, but preserved systolic function EF 65.0±2.6%, FS 35.0±0.9%. Gr.5 revealed CH with elevated EDV up to 230±3.2 ml and insignificant (P>0.5) changes in systolic function (EF 61.3±2.5%; FS 32.0±0.9%)

Conclusion: Thus, EH characteristics of insulin resistance syndrome in DM2 pts make favorable background for disturbing heart diastolic and systolic functions in presence of even moderate hypertension.