HYPERTROPHIC CARDIOMYOPATHY IN PATIENTS WITH DIABETES-MELLITUS ASSOCIATED WITH MITOCHONDRIAL TRNA(LEU(UUR)) GENE MUTATION

被引:3
作者
YOSHIDA, R [1 ]
ISHIDA, Y [1 ]
ABO, K [1 ]
HOZUMI, T [1 ]
UENO, H [1 ]
SHIOTANI, H [1 ]
KISHIMOTOHASHIRAMOTO, M [1 ]
HASHIRAMOTO, M [1 ]
MATSUNAGA, K [1 ]
KASUGA, M [1 ]
KAZUMI, T [1 ]
机构
[1] HYOGO MED CTR ADULTS,DEPT MED,DIV ENDOCRINOL & METAB,AKASHI,HYOGO,JAPAN
关键词
CONGESTIVE HEART FAILURE; ECHOCARDIOGRAPHY; HEARING LOSS;
D O I
10.2169/internalmedicine.34.953
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Left ventricular function and morphology were assessed using M-mode echocardiography in 3 patients with diabetes mellitus associated with mitochondrial tRNA(Leu(UUR)) gene mutation, who were free of clinical, electrocardiographic, or thallium scan evidence of ischemic heart disease, Echocardiograms revealed hypertrophic cardiomyopathy in all 3 patients, Hypertrophy of the interventricular septum was mild in Cases 1 and 3 (12 and 13 mm, respectively) and severe in Case 2 (22 mm) (normal 7-10 mm). When they had neither signs nor symptoms suggestive of congestive heart failure, percentage fractional shortening (%FS), an index of wall motion of the left ventricle (normal >28%), was normal in Cases 2 and 3 (28 and 32%, respectively) whereas it was slightly decreased in Case 1 (22 %), In Case 1 with mild hypertrophy, the development of congestive heart failure was associated with a marked decrease in %FS to 13%; this patient responded well to diuretics and captopril and %FS rose to 22%, However, a mild decrease in %FS to 21% caused congestive heart failure in Case 2 with severe hypertrophy, His response to treatment was marginal, The present study indicates that mitochondrial DNA analysis should be done in patients with diabetic cardiomyopathy, and that sequential echocardiography is invaluable far the detection of hypertrophic cardiomyopathy and the management of subsequent myocardial dysfunction in patients with mitochondrial diabetes mellitus and cardiomyopathy.
引用
收藏
页码:953 / 958
页数:6
相关论文
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  • [1] Fein F.S., Sonnenblick E.H., Diabetic cardiomyopathy, Prog Cardiovasc Dis, 27, (1985)
  • [2] Regan T.J., Congestive heart failure in the diabetic, Annu Rev Med, 34, (1983)
  • [3] Rubier S., Dlugash J., Yuceogle Y.Z., Et al., New type of cardiomyopathy associated with diabetic glomerulosclerosis, Am J Cardiol, 30, (1972)
  • [4] Kannel W.B., Hjortland M., Castelli W.P., Role of diabetes in congestive heart failure: the Framingham Study, Am J Cardiol, 34, (1974)
  • [5] Kishimoto M., Hashiramoto M., Araki S., Ishida Y., Kazumi T., Kasuga M., Diabetes mellitus carrying a mutation in mitochondrial tRNALeu(UUR) gene, Diabetologia, 38, (1995)
  • [6] Sahn D.J., DeMaria A., Kisslo J., Weyman A., Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements, Circulation, 58, (1978)
  • [7] Bruce R.A., Blackmon J.R., Jone J.W., Stait G., Exercising testing in adult normal subjects and cardiac patients, Pediatrics, 32, (1963)
  • [8] Goto Y., Nonaka I., Horai S., A mutation in the tRNALeu(UUR) gene associated with the MELAS subgroup of mitochondrial encephalomyopathies, Nature, 348, (1990)
  • [9] Van den Ouweland J.M.W., Lemkes H.H.P.J., Ruitenbeek W., Et al., Mutation in mitochondrial tRNALeu(UUR) gene in a large pedigree with maternally transmitted type II diabetes mellitus and deafness, Nature Gene, 1, (1992)
  • [10] Reardon W., Ross R.J.M., Sweeney M.G., Et al., Diabetes mellitus associated with a pathogenic point mutation in mitochondrial DNA, Lancet, 340, (1992)