Abstract
We determined the effects of diabetes mellitus on left ventricular (LV) diastolic function in normotensive and hypertensive subjects. The ratio of early to late peak flow velocity (E/A ratio) and deceleration time were obtained from Doppler recordings in the apical 4-chamber view with the sample volume placed at the tip of the mitral valve. The same measurements were then repeated during the Valsalva maneuver to unmask LV diastolic function abnormalities (pseudonormalization) for measuring%E/A ratio. The Valsalva maneuver helped differentiate between patients with and without pseudonormal diastolic dysfunction. The prevalence of diastolic dysfunction was lowest in patients with hypertension, intermediate in patients with diabetes mellitus, and highest in patients with both diabetes mellitus and hypertension. Interventricular septal thickening and LV mass index were similar in all 3 groups. Results suggest that LV wall stiffness is greater in the diabetic heart than in the hypertensive heart, and the examination of LV diastolic dysfunction using the Valsalva maneuver is useful in evaluating the myocardial stiffness in diabetes mellitus.
