Augmentation of Atrial Contribution to Left Ventricular Filling in IDDM Subjects as Assessed by Doppler Echocardiography

Left ventricular diastolic function was assessed by pulsed Doppler echocardiography in 21 subjects (mean age 48 yr) with insulin-dependent diabetes mellitus (IDDM) and without evidence of ischemic heart disease and in 21 healthy control subjects of similar age and sex distribution. The peak mitral valve flow velocities during the early rapid filling phase (E) and during late atrial filling (A) were measured, and the ratio of these peak flow velocities (E:A) was calculated. E was similar in both groups, but A was higher (P < .01) in the diabetic group. Thus, E A was lower (1.19 ± 0.24 vs. 1.65 ± 0.67; P <.01) in the diabetic subjects than in the control subjects. On subgroup analysis, 6 patients with cardiac autonomic neuropathy had lower E:A than the patients with no such disorder (0.99 ± 0.15 vs. 1.29 ± 0.25; P < .05). E A was not related to the duration of diabetes, presence of retinopathy, HbA,, or blood glucose levels. In conclusion, the atrial contribution to left ventricular filling seems to be augmented in diabetic subjects. This finding indirectly supports the view that left ventricular compliance is already reduced in asymptomatic diabetic subjects.