Impaired fasting glucose and left ventricular diastolic dysfunction in middle-age adults: a retrospective cross-sectional analysis of 2971 subjects

Cardiovascular Diabetology

Rafael Kuperstein⁴  Ilan Goldenberg⁷  Yechezkel Sidi⁷  Shlomo Segev¹  Aharon Erez³  Enrique Z. Fisman²  Alexander Tenenbaum⁵  Sagit Ben Zekry⁴  Anat Berkovitch³  Shaye Kivity⁴  Elad Maor⁶  Assi Milwidsky⁷ 

[1] Institute for Medical Screening, Chaim Sheba Medical Center, Ramat Gan, Israel;Cardiovascular Diabetology Research Foundation, Holon, Israel;Leviev Heart Center, Chaim Sheba Medical Center, Ramat Gan, Israel;Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel;Cardiac Rehabilitation Institute, Chaim Sheba Medical Center, Ramat Gan, Israel;Pinchas Borenstein Talpiot Medical Leadership Program, Chaim Sheba Medical Center, Ramat Gan, Israel;Department of Internal Medicine “E”, Tel-Aviv Medical Center, 6 Weizmann Street, Tel Aviv, 64239, Israel

关键词: Impaired fasting glucose;    Diabetes mellitus;    Diastolic dysfunction;   

Others  :  1225630
DOI  :  10.1186/s12933-015-0282-4

 received in 2015-08-22, accepted in 2015-08-27,  发布年份 2015

【 摘 要 】

Background

Left ventricular (LV) diastolic dysfunction (LVDD) is a well-established and early echocardiographic characteristic of diabetic cardiomyopathy. However, there are limited data on the association between impaired fasting glucose (IFG) and LVDD.

Objective

To determine whether IFG is associated with LVDD among middle age adults.

Methods

Amongst 3781 subjects screened in an annual health survey program and referred for an echocardiogram, 2971 individuals without LV systolic dysfunction or valvular heart disease were selected. Mean age of study population was 59 ± 12 years and 75 % were men. The subjects were categorized into three groups: euglycemia (N = 2025), IFG (N = 534) and diabetes mellitus (DM; N = 412). Doppler echocardiography readers were blinded to glycemic state. Subjects with impaired LV relaxation, pseudo-normal or restrictive filling patterns were defined as having LVDD.

Results

LVDD was diagnosed in 574 (19 %) of subjects and it was more prevalent among patients with IFG and DM than in euglycemic individuals (27, 30 and 15 %, respectively; p < 0.001). Patients with IFG and DM had lower ratios of early (E) to late (A) trans-mitral flow (0.9 ± 0.3 and 0.9 ± 0.3 vs. 1.1 ± 0.4, respectively, p < 0.001). LV hypertrophy (LVH) was also more prevalent among patients with IFG and DM (11 and 18 %, respectively, vs. 9 %; p < 0.001). Multivariate binary logistic regression model adjusted to age, gender, obesity, LVH, renal function, total, high and low density lipoprotein cholesterol, triglycerides, ischemic heart disease, hypertension and LV ejection fraction showed that patients with IFG were 43 % more likely to have LVDD compared with euglycemic subjects (95 % confidence interval 1.12–1.83, p = 0.004).

Conclusions

IFG is independently associated with a significant increase in the likelihood for the presence of LVDD in middle aged adults.

【 授权许可】

   
2015 Milwidsky et al.

【 图 表 】

Fig.1.

Fig.2.

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