Study of some factors involved in the occurrence of silent myocardial ischemic episodes in non insulin dependent diabetic patients

Abstract EN

-patients with silent ischemia can be divided into three categories, Patients who are totally asymptomatic, thus accidentally discovered; patients who are asymptomatic after a myocardial infarction and patients with both symptomatic and asymptomatic ischemia.

Silent ischemia in diabetic patients could also be detected by stress echocardiography which is an established method for identifying reversible myocardial dysfunction and detecting myocardial ischemia.

The aim of the work: The aim of this work was to evaluate some factors (age.

personality traits, blood pressure, autonomic function and the antiinflammatory cytokine transforming growth factor beta that may affect the occurrence of silent ischemia in non insulin dependent(type 2) diabetic patients.

Material and Methods: The study included 30 patients divided according to the results of stress echocardiography into 2 groups: -The first group was + ve for the presence of silent episodes.

-The second group was -ve for the presence of silent episodes.

The study also include 10 healthy control subjects.

The results of the present study can be summerized as follows: 43 % of the whole patients (7 males and 6 females) were + ve for the presence of silent ischemia.

Results: Regarding the factors which may affect the occurrence of silent ischemic episodes our study revealed: There was a statistically significant difference as regard the age between the stress +ve group (the age ranged from 48-70 years with a mean age of 57.

15 ± 7.

58 years) compared to the stress -ve group (the age ranged from 3 9- 65 years with a mean are of 48.

41±14, 74 years).

The percentage of hypertensive patients was significantly higher in the stress + ve eases 92.3% compared to 58.9% of the stress -ve group and non of the control subjects were hypertensive.

In addition, 61.

5 % of the stress + ve hypertensive cases showed systolic hypertension during silent ischemic episodes monitored during 24 hours 1-loiter recording.

As regard the personality type, type A personality was significantly more frequent among the stress + ve cases, 69.20 0 than type B which 70.

6 %.

The control group were 50 % of type A personality and 50 % of type B personality.The results of the 4 autonomic function tests revealed that 20 Cases out of 30 (66.

6 % of all patients group) had autonornic dysfunction.

The level of the serum transforming growth factor beta 1 (TGFB1) was higher in the patients group with a mean of 33.

43 ng/ml compared to 26.

7 ng/ml in the control subjects.

It also showed a higher level in the stress + ve cases with a mean of 37.91 ng/ml compared to 30.

01 ng/rnl in the stress-ve cases.

Conclusion: Silent myocardial ischemic episodes are common in non insulin diabetics& refers to autonomic dysfunction& the role of TGFB1