Relation of endothelial and cardiac autonomic function with
Diabetes mellitus (DM) is a risk factor for left ventricle (LV) diastolic dysfunction. Aim of this study was to investigate whether endothelial and/or autonomic dysfunction are associated with LV diastolic dysfunction in DM patients.

Researchers studied 84 non-insulin-dependent type II DM (T2DM) patients with no heart disease by assessing: 1) LV diastolic function by echocardiography; 2) peripheral vasodilator function, by measuring flow-mediated dilation (FMD) and nitrate-mediate dilation (NMD); 3) heart rate variability (HRV) on 24-hour Holter electrocardiographic monitoring.

-- Twenty-five patients (29.8%) had normal LV diastolic function, while 47 (55.9%) and 12 (14.3%) showed a mild and moderate/severe diastolic dysfunction, respectively.

-- FMD in these 3 groups was 5.25±2.0, 4.95±1.6 and 4.43±1.8%, wherease NMD was 10.8±2.3, 8.98±3.0 and 8.82±3.2%, respectively.

-- HRV variables did not differ among groups. However, the triangular index tended to be lower in patients with moderate/severe and a significant correlation was found between the E/e’ ratio and both the triangular index and LF amplitude.

Conclusively, in T2DM patients an impairment of endothelium-independent, but not endothelium-dependent, dilatation seems associated with LV diastolic dysfunction. The possible role of cardiac autonomic dysfunction in diastolic dysfunction deserves investigation in larger populations of patients.