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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

One hundred and twenty two fetal echocardiograms were performed during normal pregnancies between the 20th and 38th weeks of gestation. Freeze frame M mode and 2D imaging was used to perform the following measurements: right and left systolic and diastolic ventricular dimensions, dimensions of the two atria, aortic and pulmonary artery dimensions, fractional shortening of both ventricles, ratio of right ventricular to left ventricular end diastolic dimensions RVEDD/LVEDD, ratio of pulmonary artery to aortic dimensions PA/Ao. The causes of error or failure were analysed. The results classified by gestational age show progressive growth of all structures which double their size during the second half of the pregnancy; the "physiological" septal hypertrophy reported by some workers was not observed in this series; similarly, paradoxical septal motion was only present in 3% of the fetuses studied. The RVEDD/LVEDD ratio approached unity, which questions the classical but hypothetical concept of physiological right ventricular preponderance, a concept also queried by recent fetal Doppler intracardiac flow studies. The repertory of normal values is particularly useful for the detection of cardiac malformations and for the surveillance of some pregnancies with a high risk of cardiomyopathy, as in maternal diabetes.
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PMID:[Quantitative echography of the fetal heart]. 309 61

Wistar rats were injected with streptozotocin (SZ) at 3 days of age. This maneuver produced a marked glucose intolerance, as determined by intraperitoneal glucose tolerance tests, but plasma fasting and nonfasting glucose values remained at or near normal throughout the 12-mo study period. Hearts obtained from these glucose-intolerant rats exhibited a progressive cardiomyopathy that consisted of both contractile and metabolic abnormalities. Contractile abnormalities were characterized by reductions in aortic output, ventricular pressure, and cardiac work. Associated with these mechanical defects was a decrease in glucose utilization. These abnormalities were not ameliorated by acute exposure to insulin or changes in the work load of the heart. These results demonstrate that, in the rat, a progressive cardiomyopathy results from persistent glucose intolerance in the absence of fasting hyperglycemia. This cardiomyopathy is reminiscent of that described in human noninsulin-dependent diabetes.
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PMID:Development of a cardiomyopathy in a model of noninsulin-dependent diabetes. 315 19

A 30 year old man with DIDMOAD (diabetes insipidus, diabetes mellitus, optic atrophy and deafness) syndrome associated with myocardial disease is reported. Echocardiographic study revealed a marked symmetric left ventricular hypertrophy. Histology of the endomyocardial biopsy specimen from the right ventricle showed severe glycogen deposition in the myocytes. This case may indicate that DIDMOAD syndrome is a hereditary systemic disease affecting multiple organs, including the myocardium.
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PMID:DIDMOAD (diabetes insipidus, diabetes mellitus, optic atrophy and deafness) syndrome associated with myocardial disease. 317 80

Numerous experimental studies have implied a link between diabetes-induced abnormal lipid buildup in the myocardium and the development of cardiomyopathy. Because the diabetic state in rats is associated with lowered T3 (triiodothyronine) and T4 levels and because diabetic patients excrete large amounts of myo-inositol, a lipotropic agent, we investigated the effects of myo-inositol and T3 on the elevated myocardial lipid levels and depressed cardiac performance of streptozocin (55 mg/kg i.v.)-induced diabetic (STZ-D) rats. myo-inositol (2.5 g.kg-1.day-1 in the drinking water) and T3 (30 micrograms.kg-1.day-1 s.c.) were given for an 8-wk period 3 days after diabetes induction. Untreated diabetic rats were characterized by a decreased rate of body weight gain, hyperglycemia, and hypoinsulinemia, which were not altered after myo-inositol and/or T3 treatment. Thyroid status of diabetic animals was normalized by T3 alone or in combination with myo-inositol but not by myo-inositol alone. The elevations in plasma and myocardial lipids associated with the diabetic state were prevented by myo-inositol treatment. However, the plasma lipid and myocardial cholesterol levels in diabetic rats remained elevated or were further increased with treatment with T3 or myo-inositol plus T3. myo-inositol treatment partially improved cardiac performance in STZ-D rats. T3 treatment alone did not prevent cardiac dysfunction in diabetic rats. There was, however, some improvement in heart function in the groups treated with both myo-inositol and T3, coinciding with a significant decrease in the myocardial triacylglycerol level. The data indicate that a possible correlation may exist between elevated myocardial triacylglycerol levels and cardiac dysfunction in diabetic rats.
Diabetes 1988 Nov
PMID:Effect of myo-inositol and T3 on myocardial lipids and cardiac function in streptozocin-induced diabetic rats. 318 44

Friedreich ataxia (FRA) is an autosomal recessive neuromuscular disorder in which nearly all affected homozygotes eventually develop significant cardiomyopathy and a substantial proportion also develop diabetes mellitus. Diabetes and early heart disease have been observed previously in close blood relatives of FRA patients. To test the hypothesis that FRA heterozygotes may have elevated rates of heart disease mortality and diabetes incidence, we compared the rates of these conditions in 1,191 adult blood relatives to those in 745 nonblood relative spouse controls in 27 families of FRA patients. We found no evidence for an excess of diabetes in the blood relatives. For three broad categories of circulatory disease mortality, the FRA blood relatives had significantly higher rates than the spouse controls. However, when each relative's prior probability of heterozygosity for the FRA gene was taken into account, the resulting estimates of relative risk of dying from circulatory disease for FRA heterozygotes compared to nonheterozygotes were not significantly elevated. Since the latter analysis provides the best test of the hypothesis, our data did not strongly support the hypothesis that FRA heterozygotes are at increased risk of cardiac death.
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PMID:Circulatory disease mortality and diabetes incidence in 27 families with Friedreich ataxia. 320 55

A survey of literature data and the author's own observation of 18 patients with hemochromatosis (H) have shown that H is a polysyndrome disease. Men aged 35 to 60 suffer more frequently. Its most significant symptoms and syndromes are skin hyperpigmentation, hypersideremia, liver cirrhosis, diabetes, cardiomyopathy, and endocrinopathy. Three variants in a course of H--mild, average severe and severe (complicated)--were defined with regard to the duration of disease, a degree of morphofunctional changes and insufficiency of the affected organs. Intravital diagnosis of H was possible in clinical awareness and in the detection of hypersideremia and hemosiderin in liver and skin biopsy specimens. Multimodality therapy (blood-letting, desferal and insulin) promoted compensation of metabolic derangement, stabilization and even regression of disease.
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PMID:[Hemochromatosis: the clinical picture, diagnosis and treatment]. 328 99

Acquired hemosiderosis resulting from massive iron deposits in various organs, including heart, liver, and pancreas, may lead to architectural and functional disturbances of these organs. Even though iron overload can occur in nonuremic as well as in uremic individuals, the dialysis patient is at particular risk for developing hemosiderosis. Many dialysis patients receive exogenous iron from either oral iron therapy or blood transfusions. In addition, these patients seem to be at high risk for retaining iron. A diagnosis of excess iron deposition should be considered if the patient has unexplained cardiomyopathy, hepatic cirrhosis, proximal myopathy, diabetes mellitus, arthropathy, or immune dysfunction such as listeriosis. Several techniques are available for determining iron overload. Diagnostic tests include measuring serum ferritin levels, staining bone marrow preparations for excess iron, measuring tissue hemosiderin concentrations, magnetic resonance imaging, and the deferoxamine (DFO; Desferal) "challenge test." The simplest treatment for iron overload in nonuremic patients is removal of iron by venesection. However, in patients in whom venesection is not feasible, the chelating agent DFO can effectively remove excess iron. In the dialysis patient, DFO therapy can be combined with either dialysis or hemoperfusion to remove the iron-DFO complex that would otherwise be removed by the kidney. DFO therapy in the nondialyzed individual has proven to be successful, but before treatment, the benefits of the treatment must be weighed against possible adverse side effects such as cataracts, changes in color vision, and anaphylaxis. In the dialysis patient, indications for iron removal are less clearly defined.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Management of iron overload in dialysis patients. 329 89

Survival and causes of death were analyzed among 163 patients with hemochromatosis diagnosed between 1959 and 1983. Mean followup was 10.5 +/- 5.6 years (+/- SD). Cumulative survival was 76% at 10 years and 49% at 20 years. Life expectancy was reduced in patients who presented with cirrhosis or diabetes compared to patients who presented without these complications at the time of diagnosis. Patients who could be depleted of iron during the first 18 months of venesection therapy had a markedly better prognosis compared to those patients who could not be depleted during this time period, probably due to greater amounts of excessive iron. Prognosis was not influenced by sex. Patients without cirrhosis or diabetes had a life expectancy that was virtually identical to that of an age-matched normal population. Analysis of the causes of death in 53 patients showed that liver cancer (n = 16) was 219 times more frequent, cardiomyopathy (n = 3) was 306 times more frequent, liver cirrhosis (n = 10) was 13 times more frequent, and diabetes mellitus (n = 3) was seven times more frequent compared to death rates expected for an age-matched normal population. The risk of death from other causes, including extrahepatic cancer (n = 7), did not differ from rates expected. Thus, patients with hemochromatosis diagnosed in a precirrhotic stage and treated by venesection have a normal life expectancy. Cirrhotic patients had a shortened life expectancy and a high risk of death from liver cancer even when complete iron depletion has been achieved.
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PMID:Survival and causes of death in hemochromatosis. Observations in 163 patients. 338 43

Acromegaly involves cardiovascular complications mostly due to the presence of hypertension, diabetes and atherosclerosis. However the appearance of cardiac decompensation and arrhythmias in the absence of predisposing factors tends to support the hypothesis of a specific myocardiopathy caused by excess GH. In order to assess the existence and course of subclinical cardiac alterations, 8 acromegaly patients were examined: 4 males and 4 females aged 31-56 with GH levels of 24-70 ng/ml (M + CD X 47 +/- 16) and no cardiovascular symptoms. One of the patients had moderate hypertension and 2 reduced glucose tolerance. The basal ECG showed sporadic ventricular extrasystoles in 2 cases and alterations compatible with left ventricular hypertrophy in another, while the effort ECG produced an asymptomatic depression of the ST segment in the hypertensive patient. The chest X-ray was normal in all cases. The echocardiography study investigated: the thickness of the interventricular septum (IVS = 13.9 +/- 2.8 mm), the thickness of the posterior wall of the left ventricle (LPW = 10.6 +/- 2.9 mm), the septum/posterior wall ratio (IVS/LPW = 1.3 +/- 0.2 the diastolic diameter (DD = 15.4 +/- 11.4 mm), the fraction of shortening (FS = 39.1 +/- 14.5%), the ejection fraction (EF = 64.1 +/- 18.4%) and revealed asymmetrical septal hypertrophy in 3 cases, concentric hypertrophy in another two. In two cases the DD and EF were distinctly altered. The patients were re-examined 2-4 years after surgical or radiation treatment. GH levels (M +/- SD = 10.3 +/- 10.1 ng/ml) were normal in 4 cases and still high, though lower in another two. The remaining two patients had borderline GH levels with high Sm-C. The ECG and chest X-ray were unchanged while echocardiography revealed a significant deterioration in heart function as far as DD (56.4 +/- 10.8 mm, p less than 0.05) were concerned with frankly pathological results in 4 and 3 cases respectively. These data confirm the view that most acromegalic patients present subclinical abnormalities in cardiac function and that the evolution of these is slightly influenced by the reduction in GH and Sm-C. levels. In fact, while the persistence of high GH and Sm-C. levels may explain the progression of cardiac alterations in some cases, it does not in others. It is also emphasised that echocardiography appears to be the most sensitive non-invasive technique for the diagnosis and follow-up of cardiac involvement in acromegaly.
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PMID:[Cardiological findings in acromegaly]. 343 27

Diabetes mellitus causes a cardiomyopathy in human subjects, independent of atherosclerotic coronary artery disease. Ventricular papillary muscle function studies in chronically diabetic rats and rabbits have shown diminished contractility and a prolonged duration of contraction. In rats there was complete reversibility of these changes with insulin therapy. However, the effects of insulin on the myocardial mechanics of diabetic rabbits have not been studied. Therefore, rabbits diabetic for 3-4 mo (after alloxan injection) were treated with PZI insulin for 3-4 mo, and the mechanical performance of their right ventricular papillary muscles was compared with that of untreated diabetic animals and age-matched controls. Insulin therapy normalized serum glucose concentration. All abnormalities in papillary muscle function were completely reversed in insulin-treated animals. Norepinephrine (NE) dose responses were also evaluated in muscles from all groups. There were no differences in the positive inotropic effects of NE between groups. However, the data suggested, in diabetic animals a blunted response of peak relaxation rate to NE; this abnormality was reversed in muscles from treated animals. These findings indicate that previous work on diabetic rats can be extended to diabetic rabbits and suggest that chronic insulin therapy completely reverses the contractile alterations in hearts from these diabetic animals.
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PMID:Reversibility of diabetic cardiomyopathy with insulin in rabbits. 351 May 67


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