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Abnormalities of the Cardiovascular Response to Cold Pressor Test in Type 1 DiabetesCorrelation With Blood Glucose Control
Howard S. Friedman, MD;
Alan Sacerdote, MD;
Ionel Bandu, MD;
Felipe Jubay, Jr, MD;
Anastacio G. Herrera, Jr, MD;
Balendu C. Vasavada, MD;
Sheldon J. Bleicher, MD
Arch Intern Med. 1984;144(1):43-47.
Abstract
• Left-ventricular (LV) function in type 1 diabetics without clinical heart disease was compared with that found in matched normal subjects. Although diabetics had a normal LV ejection fraction (66%±6%), they showed a trend toward smaller left ventricles. Their cardiovascular response to a cold pressor test was abnormal and cardiac function after the cold pressor test correlated with hemoglobin A1c levels: Average hemoglobin A1c was inversely related to ejection fraction and early filling volume and directly related to the ratio of preejection period to ejection time (PEP/LVET) after a cold pressor test. Hemoglobin A1c at the time of study correlated more closely with PEP/LVET after cold pressor test than did the six-month average hemoglobin A1c level, suggesting that cardiac function fluctuates with recent changes in blood glucose control. Thus, even when diabetics have a normal LV ejection fraction, an abnormal cardiovascular response to stress may still be present, and such abnormalities correlate with blood glucose control.
(Arch Intern Med 1984;144:43-47)
Author Affiliations
From the Sections of Cardiology (Drs Friedman, Bandu, and Vasavada) and Endocrinology (Drs Sacerdote, Jubay, Herrara, and Bleicher), and the Diabetes Endocrine Center (Drs Sacerdote, Jubay, Herrara, and Bleicher), the Department of Medicine, Brooklyn (NY) Hospital and the Downstate Medical Center, State University of New York, Brooklyn.
Footnotes
Accepted for publication June 26, 1983.
Read in part before the annual meeting of the American Diabetes Association, Cincinnati, June 15, 1981, and the eastern section meeting of the American Federation for Clinical Research, Boston, Oct 23, 1981.
Reprint requests to Brooklyn Hospital, 121 Dekalb Ave, Brooklyn, NY 11201 (Dr Friedman).
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