Diabetes mellitus(DM) has been found to be an impendent risk for decreasing congestive heart failure and decreasing left ventricular function. However, right ventricular dysfunction has not been studied in detail patients with DM. The goal of this study was to evaluate the occurrence of left and right ventricular dysfunction in diabetes patients.
Randomly selected case of 200 patients, who underwent left ventricular ejection fraction (LVEF) determination using blood pooled scintigraphy, underwent simultaneous measurement of right ventricular ejection fraction (RVEF). The presence of diabetes mellitus was studied in patients with depressed LVEF and RVEF using uni- and multi-variate analysis.
A total of 152 patients had RVEF and 155 LVEF measurements. Four out of 26 DM patients had RVEF less than 30 % (15.4%) vs 4 of 126 control ( 3,2%), p=0.01. Eleven out of 27 (40.7%) patients with DM had LVEF less than 30% vs 9 out of 128 patients (7%) of control, p<0.0001 Using multivariate analysis adjusting for coronary artery disease, hypertension and chronic obstructive pulmonary disease, DM remained independently associated with LVEF or RVEF less than 30% (for RVEF < 30%: odds ratio: 5.7 CI: 1.3-25.4, p= 0.02), for LVEF, 30%: odds ratio: 12.9 CI: 3.8-43.7).
Diabetes mellitus is independently associated with left and right ventricular dysfunction. The involvement of both ventricles in DM patients, suggest that diabetic causes global toxic effect on myocardial cells.
The deleterious effect of diabetes mellitus on global right and left ventricles, in part, may explain high mortality rate in this population.
Mohammad-Reza Movahed, None.