Study on the relationship between lower limb artherosclerosis and cardiac function in elderly patients with diabetes mellitus complicated with coronary heart disease / 中华老年医学杂志

ABSTRACT

Objective To investigate the relationship between lower limb artherosclerosis and cardiac function in elderly patients with diabetes mellitus(DM)complicated with coronary heart disease (CHD). Methods 441 cases of elderly patients were divided into four groups the group with CHD (n=117), the group with DM(n=42), the group with DM compllicated with CHD( DM±CHD, n=132),the group without DM and CHD(NC,n=150). Systolic blood pressure (SBP), diastolic blood pressure(DBP), pulse pressure (PP), braehial-ankle pulse wave velocity (baPWV), ankle-brachial index(ABl) and toe-brachial index(TBI) were measured by the auto-survey artherosclerosis apparatus.Left ventricular posterior wall (LVPW), left atrium (LA), fractional shortening (FS), ejection fraction(EF) and EF slope were measured by the two-dimensional echocardiography. Results The baPWV was significantly higher in DM+CHD group than in DM group and NC group[(20125±354)cm/s vs (1849±467)cm/s, (1863±347) cm/s. P<0.05]. The ABI was significantly lower in DM±CHD group compared with NC, CHD and DM groups (0.91±0.23 vs 1.15±0.11,1.07±0.16 and 1.06±0.14. all P＜0.05). There were significant differences in TBI among four groups(all P<0.05)NC group(0.905±0.15)>CHD group(0.805±0.16)>DM group(0.71±0.17)>DM+CHD group(0.625±0.17). The LA and the LVPW were significantly higher in DM+CHD group than in NC group(P<0.05). The FS and EF slopes were significantly lower in the DM+CHD group than in DM group (P<0.05) and NC group(P<0.05). The EF in DM+CHD group was significantly lower than that in other three groups (P<0.05). BaPWV showed a strong negative association with FS,EF and EF slope(r-0.112,-0.151,-0.275. all P<0.05). ABI showed a strong positive association with FS,EF and EF slope(r0.150,0.186,0.260. all P<0.01) ,TBI was found to have strong negative association with LA and LVPW ( r-0.158,-0.171;all P<0.01) and have strong positive association with FS,EF and EF slope(r0.163,0.197,0.243.all P<0.01). Conclusions The lower limb artherosclerosis is serious and cardiac function is significantly decreased in elderly patients with diabetes mellitus complicated with coronary heart disease. PWV,ABI and TBI are closely related with cardiac function and can reflect the state of cardiac function in some extent.