Circulation, Vol 82, 848-855, Copyright © 1990 by American Heart Association
KH van Hoeven and SM Factor
The hearts obtained at autopsy of 67 patients with hypertension, diabetes
mellitus, or both were examined microscopically and histochemically, and
the amount of fibrosis was determined. Significant differences in heart
weight, interstitial fibrosis, replacement fibrosis, and perivascular
fibrosis were found among the groups. The mean heart weight of the
hypertensive-diabetic patients was significantly greater than that of the
hypertensive patients and the diabetic patients. The amount of microscopic
fibrosis increased between the groups, the lowest in hypertensive hearts,
midrange in diabetic hearts, and highest in hypertensive-diabetic hearts.
Total fibrosis correlated with heart weight among diabetic and
hypertensive-diabetic patients and was significantly greater among patients
with congestive heart failure, most of whom had histories of both
hypertension and diabetes. The microscopic grade of fibrosis correlated
significantly (p less than 0.01) with a quantitative, histochemical
determination of the amount of collagen per milligram of total
noncollagenous protein in the heart tissue. Myocardial fibrosis may
contribute to the diastolic dysfunction typical of hypertensive-diabetic
cardiomyopathy, in which congestive heart failure is a common sequela. The
importance of hypertension in the pathogenesis of severe diabetic heart
disease is discussed.
ARTICLES
A comparison of the pathological spectrum of hypertensive, diabetic, and hypertensive-diabetic heart disease
Department of Pathology, Albert Einstein College of Medicine, Bronx, New York 10461.
This article has been cited by other articles:
 |
|
 |
|
  K. Swaminathan, J. Davies, and A. Struthers Review: Aldosterone antagonism in type 2 diabetes mellitus -- a new therapeutic approach to diabetic macrovascular disease? The British Journal of Diabetes & Vascular Disease, January 1, 2008; 8(1): 16 - 19. [Abstract] [PDF]
|
|
|
|
 |
|
 L. van Heerebeek, N. Hamdani, M. L. Handoko, I. Falcao-Pires, R. J. Musters, K. Kupreishvili, A. J.J. Ijsselmuiden, C. G. Schalkwijk, J. G.F. Bronzwaer, M. Diamant, et al. Diastolic Stiffness of the Failing Diabetic Heart: Importance of Fibrosis, Advanced Glycation End Products, and Myocyte Resting Tension Circulation, January 1, 2008; 117(1): 43 - 51. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. Z. Ben-Dov, D. Ben-Ishay, J. Mekler, L. Ben-Arie, and M. Bursztyn Increased Prevalence of Masked Blood Pressure Elevations in Treated Diabetic Subjects Arch Intern Med, October 22, 2007; 167(19): 2139 - 2142. [Full Text] [PDF]
|
|
|
|
 |
|
 R. Wachter, C. Luers, S. Kleta, K. Griebel, C. Herrmann-Lingen, L. Binder, N. Janicke, D. Wetzel, M. M. Kochen, and B. Pieske Impact of diabetes on left ventricular diastolic function in patients with arterial hypertension Eur J Heart Fail, May 1, 2007; 9(5): 469 - 476. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. E. Gilbert, K. Connelly, D. J. Kelly, C. A. Pollock, and H. Krum Heart Failure and Nephropathy: Catastrophic and Interrelated Complications of Diabetes Clin. J. Am. Soc. Nephrol., March 1, 2006; 1(2): 193 - 208. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Chung, P. Abraszewski, X. Yu, W. Liu, A. J. Krainik, M. Ashford, S. D. Caruthers, J. B. McGill, and S. A. Wickline Paradoxical Increase in Ventricular Torsion and Systolic Torsion Rate in Type I Diabetic Patients Under Tight Glycemic Control J. Am. Coll. Cardiol., January 17, 2006; 47(2): 384 - 390. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Fiorina, C. Gremizzi, P. Maffi, R. Caldara, D. Tavano, L. Monti, C. Socci, F. Folli, F. Fazio, E. Astorri, et al. Islet Transplantation Is Associated With an Improvement of Cardiovascular Function in Type 1 Diabetic Kidney Transplant Patients Diabetes Care, June 1, 2005; 28(6): 1358 - 1365. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Y. Wong, W. Rosamond, P. P. Chang, D. J. Couper, A. R. Sharrett, L. D. Hubbard, A. R. Folsom, and R. Klein Retinopathy and Risk of Congestive Heart Failure JAMA, January 5, 2005; 293(1): 63 - 69. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Z. Y. Fang, J. B. Prins, and T. H. Marwick Diabetic Cardiomyopathy: Evidence, Mechanisms, and Therapeutic Implications Endocr. Rev., August 1, 2004; 25(4): 543 - 567. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S Shah, M K Davies, D Cartwright, and P Nightingale Management of chronic heart failure in the community: role of a hospital based open access heart failure service Heart, July 1, 2004; 90(7): 755 - 759. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. H. Andersen, S. H. Poulsen, K. Helleberg, P. Ivarsen, S. T. Knudsen, and C. E. Mogensen Impact of Essential Hypertension and Diabetes Mellitus on Left Ventricular Systolic and Diastolic Performance Eur J Echocardiogr, December 1, 2003; 4(4): 306 - 312. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Z. Y. Fang, O. Najos-Valencia, R. Leano, and T. H. Marwick Patients with early diabetic heart disease demonstrate a normal myocardial response to dobutamine J. Am. Coll. Cardiol., August 6, 2003; 42(3): 446 - 453. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. E. Liu, D. C. Robbins, V. Palmieri, J. N. Bella, M. J. Roman, R. Fabsitz, B. V. Howard, T. K. Welty, E. T. Lee, and R. B. Devereux Association of albuminuria with systolic and diastolic left ventricular dysfunction in type 2 diabetes: The Strong Heart Study J. Am. Coll. Cardiol., June 4, 2003; 41(11): 2022 - 2028. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Amenta, E. Peleg, D. Tomassoni, M. Sabbatini, and T. Rosenthal Effect of Treatment With Lercanidipine on Heart of Cohen-Rosenthal Diabetic Hypertensive Rats Hypertension, June 1, 2003; 41(6): 1330 - 1335. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Z. Y. Fang, S. Yuda, V. Anderson, L. Short, C. Case, and T. H. Marwick Echocardiographic detection of early diabetic myocardial disease J. Am. Coll. Cardiol., February 19, 2003; 41(4): 611 - 617. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. C. Sampaio, J. E. Tanus-Santos, S. E. S. F. C. Melo, S. Hyslop, K. G. Franchini, I. M. Luca, and H. Moreno Jr Hypertension Plus Diabetes Mimics the Cardiomyopathy Induced by Nitric Oxide Inhibition in Rats Chest, October 1, 2002; 122(4): 1412 - 1420. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Davies and A. Struthers Review: The potential benefits of aldosterone antagonism in Type 2 diabetes mellitus Journal of Renin-Angiotensin-Aldosterone System, September 1, 2002; 3(3): 150 - 155. [Abstract] [PDF]
|
|
|
|
|
|
J. E. Liu, V. Palmieri, M. J. Roman, J. N. Bella, R. Fabsitz, B. V. Howard, T. K. Welty, E. T. Lee, and R. B. Devereux The impact of diabetes on left ventricular filling pattern in normotensive and hypertensive adults: the strong heart study J. Am. Coll. Cardiol., June 1, 2001; 37(7): 1943 - 1949. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Kuperstein, P. Hanly, M. Niroumand, and Z. Sasson The importance of age and obesity on the relation between diabetes and left ventricular mass J. Am. Coll. Cardiol., June 1, 2001; 37(7): 1957 - 1962. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Lye and N. Wisniacki Heart failure in the elderly: a diastolic problem? Eur J Heart Fail, June 1, 2000; 2(2): 133 - 136. [Full Text] [PDF]
|
|
|
|
|
|
S. M. Grundy, I. J. Benjamin, G. L. Burke, A. Chait, R. H. Eckel, B. V. Howard, W. Mitch, S. C. Smith Jr, and J. R. Sowers Diabetes and Cardiovascular Disease : A Statement for Healthcare Professionals From the American Heart Association Circulation, September 7, 1999; 100(10): 1134 - 1146. [Full Text] [PDF]
|
|
|
|
 |
|
 P. S. PARFREY and R. N. FOLEY The Clinical Epidemiology of Cardiac Disease in Chronic Renal Failure J. Am. Soc. Nephrol., July 1, 1999; 10(7): 1606 - 1615. [Full Text]
|
|
|
|
|
|
M. Romanens, S. Fankhauser, B. Saner, L. Michaud, and H. Saner No evidence for systolic or diastolic left ventricular dysfunction at rest in selected patients with long-term Type I diabetes mellitus Eur J Heart Fail, June 1, 1999; 1(2): 169 - 175. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R S McKelvie, C R Benedict, and S Yusuf Evidence based cardiology: Prevention of congestive heart failure and management of asymptomatic left ventricular dysfunction BMJ, May 22, 1999; 318(7195): 1400 - 1402. [Full Text]
|
|
|
|
|
|
Y. Momiyama, Y. Suzuki, F. Ohsuzu, Y. Atsumi, K. Matsuoka, and M. Kimura Maternally transmitted susceptibility to non-insulin-dependent diabetes mellitus and left ventricular hypertrophy J. Am. Coll. Cardiol., April 1, 1999; 33(5): 1372 - 1378. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. L. Dini, C. Volterrani, A. Azzarelli, A. Lanciani, M. Lunardi, D. Bernardi, and G. Micheli Left Ventricular Size and Function in Patients with Noninsulin-Dependent Diabetes and Postinfarction Total or Subtotal Coronary Occlusions Angiology, December 1, 1998; 49(12): 967 - 973. [Abstract] [PDF]
|
|
|
|
|
|
R. W. Nesto and S. Zarich Acute Myocardial Infarction in Diabetes Mellitus : Lessons Learned From ACE Inhibition Circulation, January 13, 1998; 97(1): 12 - 15. [Full Text] [PDF]
|
|
|
|
|
|
S. Kim, H. Wanibuchi, A. Hamaguchi, K. Miura, S. Yamanaka, and H. Iwao Angiotensin Blockade Improves Cardiac and Renal Complications of Type II Diabetic Rats Hypertension, November 1, 1997; 30(5): 1054 - 1061. [Abstract] [Full Text]
|
|
|
|
 |
|
 H. Wakasaki, D. Koya, F. J. Schoen, M. R. Jirousek, D. K. Ways, B. D. Hoit, R. A. Walsh, and G. L. King Targeted overexpression of protein kinase C beta 2 isoform in myocardium causes cardiomyopathy PNAS, August 19, 1997; 94(17): 9320 - 9325. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Yagi, S. Kim, H. Wanibuchi, T. Yamashita, Y. Yamamura, and H. Iwao Characteristics of Diabetes, Blood Pressure, and Cardiac and Renal Complications in Otsuka Long-Evans Tokushima Fatty Rats Hypertension, March 1, 1997; 29(3): 728 - 735. [Abstract] [Full Text]
|
|
|
|
|
|
D. Levy, M. G. Larson, R. S. Vasan, W. B. Kannel, and K. K. L. Ho The Progression From Hypertension to Congestive Heart Failure JAMA, May 22, 1996; 275(20): 1557 - 1562. [Abstract] [PDF]
|
|
|
|
|
|
A. Jain, G. Avendano, S. Dharamsey, A. Dasmahapatra, R. Agarwal, A. Reddi, and T. Regan Left Ventricular Diastolic Function in Hypertension and Role of Plasma Glucose and Insulin : Comparison With Diabetic Heart Circulation, April 1, 1996; 93(7): 1396 - 1402. [Abstract] [Full Text]
|
|
|
|
|
|
E. Grossman, J. Shemesh, A. Shamiss, M. Thaler, J. Carroll, and T. Rosenthal Left Ventricular Mass in Diabetes-Hypertension Arch Intern Med, May 1, 1992; 152(5): 1001 - 1004. [Abstract] [PDF]
|
|