Contribuição ao estudo da cardiomiopatia diabetica : o coração diabetico e os pequenos vasos intramiocardicos (correlação clinico-patologica)

AUTOR(ES)
DATA DE PUBLICAÇÃO

1993

RESUMO

In this study, we analysed the hearts from 137 diabetic individuals necropsied as to their clinical manifestations and anatomo-pathological alterations. We believe that hyperglycemia causes direct deleterions effects towards the myocyte enzimes, which regulate the ionic and contractile balance, leading to an electric instabilyty and myo cardial depression. At long term the effects of hyperglycemia on heart are due to alterations of the permeability of intramyocardial small vessels, which through multiple alterations of main homeostatic mechanism progressively injure interstice and myocyte. The most frequent clinical manifestations are: typical pre cordialgy in the absence of obstructive coronaryopathy which justifies it and the symptoms and signals resulting from ventricular insufficiency, initialy diastolic. Routine subsidiary exams, such as electrocardiogram at rest and usual radiologic exam, do not constitute neither appropriate not sufficient aid for diagnosis since the lesions are small and focal. The anatomo-pathological exam identifies the prevalent lesions but not the pathognomonic ones of diabetes. However, the focal nature of the observed lesions establishes an exclusive characteristic of diabetes. Due to such nature, Diabetic Cardiomypathy can be diagnosed by anatomo-pathological exam, even when it is associated to other types of cardiopathy, which frequency is very high in diabetes. We observed that in studied, focal the 137 individuals studied, focal lesions corresponded to 61.31 % of the total cases. Such individuals suggered from Diabetic Cardiomiopathy, which we believe to be resulting from the lesion of intramyocardic small vessels. From there groups, 16.78 % are diabetics without any other associated cardiovascular pathologies and 71.53 % are diabetics with other mechanisms of lesion, mainly represented by Systemic Arterial Hypertension and Obstructive Coronariopathy. A poor glicemic control was predominant in the anatomo-pathological lesions observed in exclusively diabetic individuals. The hyperglycemic metabolic medium was also essential for the of arteriosclerotic severe macroangiopathy in occurrence obstructive forms, greater than 50.00 % and mainly between 70 and 100 %

ASSUNTO(S)

angiopatias diabeticas diabetes mellitus

ACESSO AO ARTIGO

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