Effect of acute ketoacidosis on the myocardium in diabetes

The American Journal of the Medical Sciences
A K GeorgeT J Regan

Abstract

Abnormalities of left ventricular function are often present in patients with diabetes who are in a stable metabolic state. To determine whether acute metabolic abnormalities may contribute to pathogenesis, patients with diabetes and ketoacidosis (Group 1) or hyperglycemia without ketosis (Group 2) were studied. They were assessed noninvasively for evidence of acute injury or dysfunction of the myocardium. Left ventricular function was assessed on admission and after clinical recovery. Myocardial enzyme release was examined during the acute phase. In Group 1, plasma glucose averaged 32 mM/L and carbon dioxide content 12.4 mEq/L. On echocardiography, the initial circumferential shortening velocity of 1.85 + 0.07 circumferences per second was significantly higher than the final circumferential shortening velocity of 1.31 + 01 (P < 0.005). The systolic time interval ratio, pre-ejection period/left ventricular ejection time, was significantly lower on the initial day compared with the second study. These data are consistent with enhanced ventricular performance. In group 2, plasma glucose averaged 29 mM/L, and carbon dioxide content was normal. The initial circumferential shortening velocity of 1. 1 circumferences per second and pr...Continue Reading

Citations

Nov 10, 2009·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Viktor Rosival
Jun 7, 2008·British Journal of Anaesthesia·J M Handy, N Soni
Sep 30, 2003·Diabetes Care·Martin TretjakMarko Noc
Jun 8, 2011·British Journal of Hospital Medicine·Simon W DubreySheila Shah
Jun 15, 2011·British Journal of Hospital Medicine·Viktor Rosival
Jun 21, 2020·Medicina·Abdullah M Al AlawiHenrik Falhammar
May 5, 2021·The American Journal of the Medical Sciences·Edgar Francisco Carrizales-SepúlvedaAlejandro Ordaz-Farías

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