Reduced left ventricular afterload and increased contractility in children with insulin-dependent diabetes mellitus: An M-mode and Doppler-echocardiographic evaluation of left ventricular diastolic and systolic function

Summary Twenty-three children with diabetes mellitus, their ages ranging from 0.2–9.8 years, but with no sign of diabetic microvascular disease were investigated by M-mode and Doppler echocardiography, along with a comparable group of control subjects. In the diabetics, the fractional shortening and the mean velocity of fractional shortening were 14 and 18% higher, respectively, whereas the left ventricular end-systolic wall stress, an indicator of left ventricular afterload, was markedly reduced (22%). Assuming an unchanged preload in the two groups, this indicates a reduced afterload in these children. Systolic and diastolic time intervals, heart rate, and blood pressure were similar in diabetics and controls. Doppler-derived transmitral left ventricular filling indices were also similar. Thus, in these diabetic children no signs of left ventricle is considered to be due to a reduced afterload in early insulin-dependent diabetes.