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Dienda YM, On'kin JBKL, Natuhoyila AN, Lubenga Y, Swambulu TM, M'buyamba-Kabangu JR, Longo-Mbenza B, Phanzu BK. Correlations of Serum Lipid Parameters and Atherogenic Indices With Left Ventricular Diastolic Dysfunction Among Apparently Healthy Patients With Type 2 Diabetes Mellitus: A Multicenter In-Hospital Cross-Sectional Study. J Diabetes Res 2024; 2024:4078281. [PMID: 39035683 PMCID: PMC11260213 DOI: 10.1155/2024/4078281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 03/11/2024] [Accepted: 06/20/2024] [Indexed: 07/23/2024] Open
Abstract
Background: In adolescents with Type 1 diabetes, lipid ratios are predictors of left ventricular diastolic dysfunction (LVDD). However, whether this also applies to adults with Type 2 Diabetes Mellitus (T2DM) is unclear. This study is aimed at assessing the correlations of serum lipid parameters and atherogenic indices with LVDD in patients with T2DM. Methods: This cross-sectional study included 203 patients with T2DM aged 59.9 ± 13.6 years (111 males, sex ratio: 1 : 2 in favor of males) from eight randomly selected urban hospitals. Demographic information was collected, an anthropometric assessment was performed, and blood pressure was measured. Fasting blood samples were obtained to assess total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TGs), glucose, and glycated hemoglobin. The atherogenic index of plasma (AIP), Castelli Risk Index I (CRI-I), Castelli Risk Index II (CRI-II), atherogenic coefficient, and non-HDL-C were determined using specific formulas. Diastolic function was assessed using echocardiography as per the 2016 updated guidelines of the American Society of Echocardiography (ASE) and the European Association of Cardiovascular Imaging (EACVI). Results: Approximately 47.8% of the participants had LVDD. Compared with participants with normal diastolic function, those with LVDD were more likely to be older than 55 years (p < 0.001), tended to have obesity (p = 0.045), had a higher risk of developing dyslipidemia (p = 0.041), and higher AIP and CRI-II (p < 0.05) levels while having similar low HDL-C and hypertriglyceridemia frequencies. In the multivariate model adjusting for age, high AIP (adjusted odds ratio [aOR], 3.37; 95% confidence interval [CI], 1.22-5.34) and high CRI-II (aOR: 3.80; 95% CI: 2.25-6.35) were independent determinants of LVDD. Conclusions: These results highlight the importance of considering atherogenic indices, primarily AIP and CRI-II in the management of T2DM patients. High AIP and high CRI-II could serve as surrogate markers of LVDD, an early cardiovascular manifestation in patients with T2DM.
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Affiliation(s)
- Yves Mayambu Dienda
- Cardiology UnitUniversity Hospital of KinshasaUniversity of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Jean-Bosco Kasiam Lasi On'kin
- Unit of Endocrinology and MetabolismUniversity Hospital of KinshasaUniversity of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | | | - Yves Lubenga
- Cardiology UnitUniversity Hospital of KinshasaUniversity of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Tresor Mvunzi Swambulu
- Cardiology UnitUniversity Hospital of KinshasaUniversity of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Jean-René M'buyamba-Kabangu
- Cardiology UnitUniversity Hospital of KinshasaUniversity of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Benjamin Longo-Mbenza
- Cardiology UnitUniversity Hospital of KinshasaUniversity of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Bernard Kianu Phanzu
- Cardiology UnitUniversity Hospital of KinshasaUniversity of Kinshasa, Kinshasa, Democratic Republic of the Congo
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2
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Wang N, Benemerito I, Sourbron SP, Marzo A. An In Silico Modelling Approach to Predict Hemodynamic Outcomes in Diabetic and Hypertensive Kidney Disease. Ann Biomed Eng 2024:10.1007/s10439-024-03573-2. [PMID: 38969955 DOI: 10.1007/s10439-024-03573-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 06/27/2024] [Indexed: 07/07/2024]
Abstract
Early diagnosis of kidney disease remains an unmet clinical challenge, preventing timely and effective intervention. Diabetes and hypertension are two main causes of kidney disease, can often appear together, and can only be distinguished by invasive biopsy. In this study, we developed a modelling approach to simulate blood velocity, volumetric flow rate, and pressure wave propagation in arterial networks of ageing, diabetic, and hypertensive virtual populations. The model was validated by comparing our predictions for pressure, volumetric flow rate and waveform-derived indexes with in vivo data on ageing populations from the literature. The model simulated the effects of kidney disease, and was calibrated to align quantitatively with in vivo data on diabetic and hypertensive nephropathy from the literature. Our study identified some potential biomarkers extracted from renal blood flow rate and flow pulsatility. For typical patient age groups, resistive index values were 0.69 (SD 0.05) and 0.74 (SD 0.02) in the early and severe stages of diabetic nephropathy, respectively. Similar trends were observed in the same stages of hypertensive nephropathy, with a range from 0.65 (SD 0.07) to 0.73 (SD 0.05), respectively. Mean renal blood flow rate through a single diseased kidney ranged from 329 (SD 40, early) to 317 (SD 38, severe) ml/min in diabetic nephropathy and 443 (SD 54, early) to 388 (SD 47, severe) ml/min in hypertensive nephropathy, showing potential as a biomarker for early diagnosis of kidney disease. This modelling approach demonstrated its potential application in informing biomarker identification and facilitating the setup of clinical trials.
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Affiliation(s)
- Ning Wang
- INSIGNEO Institute for In Silico Medicine, The University of Sheffield, Sheffield, UK.
- Department of Mechanical Engineering, The University of Sheffield, Sheffield, UK.
- The University of Sheffield, Room E09, The Pam Liversidge Building, Mappin Street, Sheffield, S13JD, UK.
| | - Ivan Benemerito
- INSIGNEO Institute for In Silico Medicine, The University of Sheffield, Sheffield, UK
- Department of Mechanical Engineering, The University of Sheffield, Sheffield, UK
| | - Steven P Sourbron
- INSIGNEO Institute for In Silico Medicine, The University of Sheffield, Sheffield, UK
- School of Medicine and Population Health, The University of Sheffield, Sheffield, UK
| | - Alberto Marzo
- INSIGNEO Institute for In Silico Medicine, The University of Sheffield, Sheffield, UK
- Department of Mechanical Engineering, The University of Sheffield, Sheffield, UK
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3
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Liu Y, Lu H, Zhang Y, Cai M, Guo J, Ruan X. Nomogram based on multimodal echocardiography for assessing the evolution of diabetic cardiomyopathy in diabetic patients with normal cardiac function. Front Cardiovasc Med 2022; 9:1002509. [PMID: 36204578 PMCID: PMC9530038 DOI: 10.3389/fcvm.2022.1002509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 08/30/2022] [Indexed: 11/25/2022] Open
Abstract
Background Diabetic cardiomyopathy (DCM) remains asymptomatic for many years until progression to asymptomatic left ventricular diastolic dysfunction (ALVDD), a subclinical cardiac abnormality present in early-stage DCM. Because LV function in patients with type 2 diabetes mellitus (T2DM) may be subtly altered long before the onset of ALVDD, quantitative assessment of the risk of progression to early-stage DCM in T2DM patients with normal hearts is critical for delaying or even reversing DCM. Objective This study aimed to establish a nomogram with the aid of DCM characteristics revealed by multimodal echocardiography to assess the likelihood of the progression to early-stage DCM in T2DM patients with normal cardiac function. Methods Of the 423 T2DM patients enrolled, 302 were included in the training cohort and 121 in the validation cohort. The clinical characteristics, biochemical data, and multimodal echocardiographic parameters were collected. In the training cohort, the screened correlates of ALVDD were utilized to develop a nomogram for estimating the risk coefficient for early-stage DCM. This model was validated both in the training and validation cohorts. Results ALVDD was independently correlated with the number of comorbidities [with one comorbidity: odds ratio (OR) = 3.009; with two comorbidities: OR = 4.026], HbA1c (OR = 1.773), myocardial blood flow (OR = 0.841), and global longitudinal strain (OR = 0.856) (all P < 0.05). They constituted a nomogram to visualize the likelihood of DCM development in T2DM patients with normal cardiac function. The model was validated to present strong discrimination and calibration, and obtained clinical net benefits both in the training and validation cohorts. Conclusion We constructed and validated a nomogram to estimate the likelihood of developing early-stage DCM in T2DM patients with normal cardiac function. The alteration of the nomogram-predicted risk coefficient is expected to be proposed as a therapeutic target to slow or stop DCM progression.
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Affiliation(s)
- Yi Liu
- Department of Ultrasonography, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hao Lu
- Department of Endocrinology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yan Zhang
- Department of Ultrasonography, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Mengjie Cai
- Department of Endocrinology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jia Guo
- Department of Ultrasonography, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- *Correspondence: Jia Guo
| | - Xiaofen Ruan
- Department of Cardiovascular Medicine, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Xiaofen Ruan
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4
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Cho DH, Joo HJ, Kim MN, Kim HD, Lim DS, Park SM. Longitudinal Change in Myocardial Function and Clinical Parameters in Middle-Aged Subjects: A 3-Year Follow-up Study. Diabetes Metab J 2021; 45:719-729. [PMID: 34126709 PMCID: PMC8497932 DOI: 10.4093/dmj.2020.0132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 02/03/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is closely associated with the aging process. However, changes in metabolic conditions and cardiac function that occur in middle aged population remain unclear. We evaluated longitudinal changes in metabolic parameters and cardiac function during a 3-year period in subjects with suspected MetS. METHODS We studied 191 participants with suspected MetS at baseline and after 3 years. Anthropometric parameters, including waist circumference (WC), and metabolic parameters, including fasting blood glucose and lipid profile were measured. Conventional echocardiography with two-dimensional speckle tracking was performed. RESULTS Mean age was 56.2±4.4 years, and there were 97 women (50.8%). Men had increased WC and triglycerides (TG) (WC 91.2±6.8 cm vs. 84.0±8.0 cm, P<0.001; TG 184.4±116.3 mg/dL vs. 128.2±53.6 mg/dL, P<0.001), and reduced global longitudinal strain (GLS) (-15.4%±2.1% vs. -17.1%±2.0%, P<0.001) compared to women. After 3.4 years, values of WC and TG did not change in men but increased in women (all P<0.05). The absolute value of left ventricular (LV) GLS did not change in men but was reduced in women (P=0.011). Change in TG was independently associated with worsening of LV GLS only in women (standardized β, -0.309; 95% confidence interval, -0.130 to -0.009; P=0.025). CONCLUSION In middle aged population, a vulnerable period for metabolic disturbance, cardiac remodeling tended to progress, which was prominent in women. Progression of adiposity and dyslipidemia after menopause may accelerate subclinical cardiac remodeling in middle-aged women. Lifestyle modification and medical interventions may help prevent further cardiac dysfunction in these subjects.
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Affiliation(s)
- Dong-Hyuk Cho
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Hyung Joon Joo
- Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Mi-Na Kim
- Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Hee-Dong Kim
- Division of Cardiology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Do-Sun Lim
- Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Seong-Mi Park
- Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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5
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Thomas JD, Gong FF. What We Learn From Exercise. JACC Cardiovasc Imaging 2020; 13:2495-2497. [DOI: 10.1016/j.jcmg.2020.06.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 06/11/2020] [Indexed: 10/22/2022]
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6
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Davarpasand T, Hosseinsabet A. Prediabetes, heart mechanics, and echocardiography: A narrative review. Echocardiography 2020; 38:304-313. [PMID: 33188654 DOI: 10.1111/echo.14929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 10/15/2020] [Accepted: 10/27/2020] [Indexed: 01/04/2023] Open
Abstract
Prediabetes is a dysglycemic state that affects many around the world and is a known risk factor for the occurrence of type 2 diabetes mellitus in the future, accompanied by vascular complications. Evidence abounds regarding myocardial involvement in prediabetes. We herein review studies having applied tissue Doppler imaging or speckle-tracking echocardiography to evaluate myocardial function in subjects with prediabetes to depict a picture of cardiac mechanics in individuals with prediabetes in comparison with patients suffering from diabetes mellitus and individuals in the normoglycemic state. Finally, we present the detrimental effects of prediabetes on cardiac mechanics.
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Affiliation(s)
- Tahereh Davarpasand
- Cardiology Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Hosseinsabet
- Cardiology Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
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7
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Zheng C, Chen Z, Zhang L, Wang X, Dong Y, Wang J, Shao L, Tian Y, Wang Z. Metabolic Risk Factors and Left Ventricular Diastolic Function in Middle-Aged Chinese Living in the Tibetan Plateau. J Am Heart Assoc 2020; 8:e010454. [PMID: 30871396 PMCID: PMC6475067 DOI: 10.1161/jaha.118.010454] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Background Data regarding the metabolic risk factors clustering on the risk of left ventricular diastolic dysfunction (LVDD) are lacking among people living at high altitude and under hypoxic conditions. In this study, we explored the association between metabolic risk factor clustering and LVDD among the Tibetan population of China. Methods and Results We conducted a cross‐sectional survey in a representative sample of 1963 Tibetans in 2014 to 2016. Grading LVDD was based on recommendations for the evaluation of LV diastolic function by echocardiography (2009). The prevalence of LVDD among 1963 participants (mean age: 51.51 years, 41.11% male) was 34.39%. Odds ratios (95% CI) of LVDD for the 1, 2, and 3 to 5 risk factors clustering were 1.45 (0.96–2.17), 2.68 (1.8–3.98), and 2.9 (1.9–4.43), respectively (P for trend <0.001). The association between metabolic risk factors clustering and LVDD was much more pronounced in the middle‐aged group than in the elderly (P for interaction=0.0170). High altitude was one of the major independent risk factors for LVDD; however, habitation altitude had no significant effect on the association between metabolic risk factors and LVDD (P for interaction=0.1022). The multivariable dominance analysis indicated that abdominal obesity, hypertension, and elevated blood glucose were the significant contributors to LVDD. Conclusions There was a significant positive association between the metabolic risk factor clustering number and LVDD among a population living at high altitude, especially in middle‐aged adults. However, habitation altitude itself has no significant effect on the association between metabolic risk factors and LVDD.
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Affiliation(s)
- Congyi Zheng
- 1 State Key Laboratory of Cardiovascular Disease National Clinical Research Center of Cardiovascular Disease Division of Prevention and Community Health National Center for Cardiovascular Disease Fuwai Hospital Peking Union Medical College & Chinese Academy of Medical Sciences Beijing China
| | - Zuo Chen
- 1 State Key Laboratory of Cardiovascular Disease National Clinical Research Center of Cardiovascular Disease Division of Prevention and Community Health National Center for Cardiovascular Disease Fuwai Hospital Peking Union Medical College & Chinese Academy of Medical Sciences Beijing China
| | - Linfeng Zhang
- 1 State Key Laboratory of Cardiovascular Disease National Clinical Research Center of Cardiovascular Disease Division of Prevention and Community Health National Center for Cardiovascular Disease Fuwai Hospital Peking Union Medical College & Chinese Academy of Medical Sciences Beijing China
| | - Xin Wang
- 1 State Key Laboratory of Cardiovascular Disease National Clinical Research Center of Cardiovascular Disease Division of Prevention and Community Health National Center for Cardiovascular Disease Fuwai Hospital Peking Union Medical College & Chinese Academy of Medical Sciences Beijing China
| | - Ying Dong
- 1 State Key Laboratory of Cardiovascular Disease National Clinical Research Center of Cardiovascular Disease Division of Prevention and Community Health National Center for Cardiovascular Disease Fuwai Hospital Peking Union Medical College & Chinese Academy of Medical Sciences Beijing China
| | - Jiali Wang
- 1 State Key Laboratory of Cardiovascular Disease National Clinical Research Center of Cardiovascular Disease Division of Prevention and Community Health National Center for Cardiovascular Disease Fuwai Hospital Peking Union Medical College & Chinese Academy of Medical Sciences Beijing China
| | - Lan Shao
- 1 State Key Laboratory of Cardiovascular Disease National Clinical Research Center of Cardiovascular Disease Division of Prevention and Community Health National Center for Cardiovascular Disease Fuwai Hospital Peking Union Medical College & Chinese Academy of Medical Sciences Beijing China
| | - Ye Tian
- 1 State Key Laboratory of Cardiovascular Disease National Clinical Research Center of Cardiovascular Disease Division of Prevention and Community Health National Center for Cardiovascular Disease Fuwai Hospital Peking Union Medical College & Chinese Academy of Medical Sciences Beijing China
| | - Zengwu Wang
- 1 State Key Laboratory of Cardiovascular Disease National Clinical Research Center of Cardiovascular Disease Division of Prevention and Community Health National Center for Cardiovascular Disease Fuwai Hospital Peking Union Medical College & Chinese Academy of Medical Sciences Beijing China
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8
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Rendón-Giraldo JA, Godoy-Palomino AL. Detección temprana de la falla cardiaca en pacientes diabéticos: Más allá de la fracción de eyección. REVISTA COLOMBIANA DE CARDIOLOGÍA 2020. [DOI: 10.1016/j.rccar.2019.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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9
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Otagaki M, Matsumura K, Kin H, Fujii K, Shibutani H, Matsumoto H, Takahashi H, Park H, Yamamoto Y, Sugiura T, Shiojima I. Effect of Tofogliflozin on Systolic and Diastolic Cardiac Function in Type 2 Diabetic Patients. Cardiovasc Drugs Ther 2019; 33:435-442. [DOI: 10.1007/s10557-019-06892-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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10
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Wu MZ, Chen Y, Zou Y, Zhen Z, Yu YJ, Liu YX, Yuen M, Ho LM, Siu-Ling Lam K, Tse HF, Yiu KH. Impact of obesity on longitudinal changes to cardiac structure and function in patients with Type 2 diabetes mellitus. Eur Heart J Cardiovasc Imaging 2019; 20:816-827. [PMID: 30629141 DOI: 10.1093/ehjci/jey217] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 11/13/2018] [Accepted: 12/29/2018] [Indexed: 12/23/2022] Open
Abstract
AIMS Few prospective studies have evaluated the natural progression of left ventricular (LV) remodelling in patients with Type 2 diabetes mellitus (T2DM). The aim of this study was to evaluate the impact of obesity on longitudinal cardiac structural and functional changes in patients with T2DM. METHODS AND RESULTS This study comprised of 274 patients with T2DM (mean age, 62.2 ± 11.4 years; male, 51.5%). Echocardiographic parameters including LV geometry, systolic, and diastolic functions were measured at baseline and follow-up. The median follow-up was 24 months (from 12 months to 48 months). The entire cohort showed a significant increase in LV wall thickness, LV mass (LVM), and prevalence of concentric hypertrophy (19.6-27.3%). Further, systolic function and diastolic function had deteriorated at follow-up assessment. Multivariable adjusted linear regression demonstrated that baseline body mass index (BMI) predicted longitudinal change to LVM (β = 0.29, P < 0.01) and LV ejection fraction (β = -0.15, P < 0.05). Patients were divided into three groups according to their BMI: normal weight (BMI <23 kg/m2), overweight (BMI between 23 kg/m2 and 27.5 kg/m2), or obese (BMI ≥27.5 kg/m2). Importantly, obesity at baseline predicted a greater longitudinal increase in LVM and decrease in LV ejection fraction compared with overweight and normal weight patients. CONCLUSION Being obese at baseline was associated with greater longitudinal increase in LV mass and greater deterioration in LV systolic function.
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Affiliation(s)
- Mei-Zhen Wu
- Division of Cardiology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Room 1929B, Block K, 102 Pokfulam Road, Hong Kong, China.,Division of Cardiology, Department of Medicine, The University of Hong Kong Shenzhen Hospital, Shenzhen, China
| | - Yan Chen
- Division of Cardiology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Room 1929B, Block K, 102 Pokfulam Road, Hong Kong, China.,Division of Cardiology, Department of Medicine, The University of Hong Kong Shenzhen Hospital, Shenzhen, China
| | - Yuan Zou
- Division of Cardiology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Room 1929B, Block K, 102 Pokfulam Road, Hong Kong, China.,Division of Cardiology, Department of Medicine, The University of Hong Kong Shenzhen Hospital, Shenzhen, China
| | - Zhe Zhen
- Division of Cardiology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Room 1929B, Block K, 102 Pokfulam Road, Hong Kong, China.,Division of Cardiology, Department of Medicine, The University of Hong Kong Shenzhen Hospital, Shenzhen, China
| | - Yu-Juan Yu
- Division of Cardiology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Room 1929B, Block K, 102 Pokfulam Road, Hong Kong, China.,Division of Cardiology, Department of Medicine, The University of Hong Kong Shenzhen Hospital, Shenzhen, China
| | - Ying-Xian Liu
- Division of Cardiology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Room 1929B, Block K, 102 Pokfulam Road, Hong Kong, China
| | - Michele Yuen
- Division of Endocrinology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
| | - Lai-Ming Ho
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Karen Siu-Ling Lam
- Division of Endocrinology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
| | - Hung-Fat Tse
- Division of Cardiology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Room 1929B, Block K, 102 Pokfulam Road, Hong Kong, China
| | - Kai-Hang Yiu
- Division of Cardiology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Room 1929B, Block K, 102 Pokfulam Road, Hong Kong, China.,Division of Cardiology, Department of Medicine, The University of Hong Kong Shenzhen Hospital, Shenzhen, China
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11
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Rueda-Ochoa OL, Smiderle-Gelain MA, Rizopoulos D, Dhana K, van den Berge JK, Echeverria LE, Ikram MA, Deckers JW, Franco OH, Kavousi M. Risk factors for longitudinal changes in left ventricular diastolic function among women and men. Heart 2019; 105:1414-1422. [PMID: 30936410 PMCID: PMC6820149 DOI: 10.1136/heartjnl-2018-314487] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 02/22/2019] [Accepted: 03/01/2019] [Indexed: 12/13/2022] Open
Abstract
Objective To evaluate changes in left ventricular diastolic function (LVDF) parameters and their associated risk factors over a period of 11 years among community-dwelling women and men. Methods Echocardiography was performed three times among 870 women and 630 men (age 67±3 years) from the prospective population-based Rotterdam Study during a period of 11-year follow-up. Changes in six continuous LVDF parameters were correlated with cardiovascular risk factors using a linear-mixed effect model (LMM). Results In women, smoking was associated with deleterious longitudinal changes in deceleration time (DT) (Beta (β): 7.73; 95% CI 2.56 to 12.9) and high-density lipoprotein cholesterol was associated with improvement of septal e′ (β: 0.37; 95% CI 0.13 to 0.62) and E/e′ ratio (β: −0.46; 95% CI −0.84 to –0.08) trajectories. Among men, diabetes was associated with deleterious longitudinal changes in A wave (β: 3.83; 95% CI 0.06 to 7.60), septal e′ (β: −0.40; 95% CI −0.70 to –0.09) and E/e′ ratio (β: 0.60; 95% CI 0.14 to 1.06) and body mass index was associated with deleterious longitudinal changes in A wave (β: 1.25; 95% CI 0.84 to 1.66), E/A ratio (β: −0.007; 95% CI −0.01 to –0.003), DT (β: 0.86; 95% CI 0.017 to 1.71) and E/e′ ratio (β: 0.12; 95% CI 0.06 to 0.19). Conclusions Smoking among women and metabolic factors (diabetes mellitus and body mass index) among men showed larger deleterious associations with longitudinal changes in LVDF parameters. The favourable association of HDL was mainly observed among women. This study, for the first time, evaluates risk factors associated with changes over time in continuous LVDF parameters among women and men and generates new hypothesis for further medical research.
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Affiliation(s)
- Oscar L Rueda-Ochoa
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.,Department of Basic Sciences, Universidad Industrial de Santander, Bucaramanga, Colombia
| | - Marco A Smiderle-Gelain
- Department of Cardiology, Federal University of Health Sciences UFCSPA, Porto Alegre, Porto Alegre, Brazil
| | | | - Klodian Dhana
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | | | - Luis E Echeverria
- Heart Failure and Heart Transplant Clinic, Fundacion Cardiovascular de Colombia, Floridablanca, Colombia
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Jaap W Deckers
- Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
| | - Oscar H Franco
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
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12
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Imazu M, Nakano A, Ito S, Hamasaki T, Kitakaze M. Effects of Teneligliptin on the Progressive Left Ventricular Diastolic Dysfunction in Patients with Type 2 Diabetes Mellitus in Open-Label, Marker-Stratified Randomized, Parallel-Group Comparison, Standard Treatment-Controlled Multicenter Trial (TOPLEVEL Study): Rationale and Study Design. Cardiovasc Drugs Ther 2019; 33:363-370. [DOI: 10.1007/s10557-019-06871-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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13
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Rutters F, Nijpels G, Elders P, Stehouwer CDA, van der Heijden AA, Groeneveld L, 't Hart LM, Dekker JM, Beulens JWJ. Cohort Profile: The Hoorn Studies. Int J Epidemiol 2019; 47:396-396j. [PMID: 29244153 DOI: 10.1093/ije/dyx227] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2017] [Indexed: 01/06/2023] Open
Affiliation(s)
- Femke Rutters
- Department of Epidemiology and Biostatistics, VU Medical Centre, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Giel Nijpels
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,Department of General Practice and Elderly Care Medicine, VU Medical Centre, Amsterdam, The Netherlands
| | - Petra Elders
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,Department of General Practice and Elderly Care Medicine, VU Medical Centre, Amsterdam, The Netherlands
| | - Coen D A Stehouwer
- Department of Internal Medicine and Cardiovascular Research Institute, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Amber A van der Heijden
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,Department of General Practice and Elderly Care Medicine, VU Medical Centre, Amsterdam, The Netherlands
| | - Lenka Groeneveld
- Department of Epidemiology and Biostatistics, VU Medical Centre, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Leen M 't Hart
- Department of Epidemiology and Biostatistics, VU Medical Centre, Amsterdam, The Netherlands.,Department of Molecular Cell Biology.,Department of Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jacqueline M Dekker
- Department of Epidemiology and Biostatistics, VU Medical Centre, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Joline W J Beulens
- Department of Epidemiology and Biostatistics, VU Medical Centre, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, The Netherlands
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14
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Matsutani D, Sakamoto M, Kayama Y, Takeda N, Horiuchi R, Utsunomiya K. Effect of canagliflozin on left ventricular diastolic function in patients with type 2 diabetes. Cardiovasc Diabetol 2018; 17:73. [PMID: 29788955 PMCID: PMC5963148 DOI: 10.1186/s12933-018-0717-9] [Citation(s) in RCA: 113] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 05/17/2018] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) greatly increases the risks of cardiovascular disease and heart failure. In particular, left ventricular diastolic dysfunction that develops from the early stages of T2DM is an important factor in the onset and exacerbation of heart failure. The effect of sodium-glucose cotransporter 2 inhibitors on left ventricular diastolic function has not been elucidated. We have performed the first prospective study on the effects of canagliflozin on left ventricular diastolic function in T2DM. METHODS This study was performed to evaluate the effects of additional treatment with canagliflozin for 3 months on left ventricular diastolic function in patients with T2DM. A total of 38 patients with T2DM were consecutively recruited for this study. Left ventricular diastolic function was assessed by echocardiography. The primary study outcome was a change in the septal E/e' as a parameter of left ventricular diastolic function. RESULTS A total of 37 patients (25 males and 12 females) were included in the analysis. Mean age of participants was 64.2 ± 8.1 years (mean ± SD), mean duration of diabetes was 13.5 ± 8.1 years, and mean HbA1c was 7.9 ± 0.7%. Of the participants, 86.5% had hypertension, 100% had dyslipidemia, and 32.4% had cardiovascular disease. Canagliflozin significantly improved left ventricular diastolic function (septal E/e' ratio 13.7 ± 3.5-12.1 ± 2.8, p = 0.001). Furthermore, among the various parameters that changed through the administration of canagliflozin, only changes in hemoglobin significantly correlated with changes in the septal E/e' ratio (p = 0.002). In multiple regression analysis, changes in hemoglobin were also revealed to be an independent predictive factor for changes in the septal E/e' ratio. CONCLUSIONS This study showed for the first time that canagliflozin could improve left ventricular diastolic function within 3 months in patients with T2DM. The benefit was especially apparent in patients with substantially improved hemoglobin values. Trial registration UMIN Clinical Trials Registry UMIN000028141.
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Affiliation(s)
- Daisuke Matsutani
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Masaya Sakamoto
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Yosuke Kayama
- Department of Cardiology, Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Norihiko Takeda
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8654, Japan
| | - Ryuzo Horiuchi
- Department of Pathology, Tsuruoka Kyoritsu Hospital, 9-34, Fumizonomachi, Tsuruoka-shi, Yamagata, 997-0816, Japan
| | - Kazunori Utsunomiya
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
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15
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Eggermont LHP, Aly MFA, Vuijk PJ, de Boer K, Kamp O, van Rossum AC, Scherder EJA. Cardiac function and cognition in older community-dwelling cardiac patients. Psychogeriatrics 2017; 17:356-363. [PMID: 28417534 DOI: 10.1111/psyg.12245] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 09/01/2016] [Accepted: 12/01/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Cognitive deficits have been reported in older cardiac patients. An underlying mechanism for these findings may be reduced cardiac function. The relationship between cardiac function as represented by different echocardiographic measures and different cognitive function domains in older cardiac patients remains unknown. METHODS An older (≥70 years) heterogeneous group of 117 community-dwelling cardiac patients under medical supervision by a cardiologist underwent thorough echocardiographic assessment including left ventricular ejection fraction, cardiac index, left atrial volume index, left ventricular mass index, left ventricular diastolic function, and valvular calcification. During a home visit, a neuropsychological assessment was performed within 7.1 ± 3.8 months after echocardiographic assessment; the neuropsychological assessment included three subtests of a word-learning test (encoding, recall, recognition) to examine one memory function domain and three executive function tests, including digit span backwards, Trail Making Test B minus A, and the Stroop colour-word test. RESULTS Regression analyses showed no significant linear or quadratic associations between any of the echocardiographic functions and the cognitive function measures. CONCLUSIONS None of the echocardiographic measures as representative of cardiac function was correlated with memory or executive function in this group of community-dwelling older cardiac patients. These findings contrast with those of previous studies.
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Affiliation(s)
- Laura H P Eggermont
- Department of Clinical Neuropsychology, VU University, Amsterdam, the Netherlands
| | - Mohamed F A Aly
- Department of Cardiology, VU University Medical Center, Amsterdam, the Netherlands.,Department of Cardiology, University Hospital, Beni-Suef, Egypt
| | - Pieter J Vuijk
- Department of Clinical Neuropsychology, VU University, Amsterdam, the Netherlands
| | - Karin de Boer
- Department of Cardiology, VU University Medical Center, Amsterdam, the Netherlands
| | - Otto Kamp
- Department of Cardiology, VU University Medical Center, Amsterdam, the Netherlands
| | - Albert C van Rossum
- Department of Cardiology, VU University Medical Center, Amsterdam, the Netherlands
| | - Erik J A Scherder
- Department of Clinical Neuropsychology, VU University, Amsterdam, the Netherlands
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16
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Cabout M, Alssema M, Nijpels G, Stehouwer CDA, Zock PL, Brouwer IA, Elshorbagy AK, Refsum H, Dekker JM. Circulating linoleic acid and alpha-linolenic acid and glucose metabolism: the Hoorn Study. Eur J Nutr 2017; 56:2171-2180. [PMID: 27418185 PMCID: PMC5579177 DOI: 10.1007/s00394-016-1261-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 06/28/2016] [Indexed: 12/25/2022]
Abstract
PURPOSE Data on the relation between linoleic acid (LA) and alpha-linolenic acid (ALA) and type 2 diabetes mellitus (T2DM) risk are scarce and inconsistent. The aim of this study was to investigate the association of serum LA and ALA with fasting and 2 h post-load plasma glucose and glycated hemoglobin (HbA1c). METHOD This study included 667 participants from third examination (2000) of the population-based Hoorn study in which individuals with glucose intolerance were overrepresented. Fatty acid profiles in serum total lipids were measured at baseline, in 2000. Diabetes risk markers were measured at baseline and follow-up in 2008. Linear regression models were used in cross-sectional and prospective analyses. RESULTS In cross-sectional analyses (n = 667), serum LA was inversely associated with plasma glucose, both in fasting conditions (B = -0.024 [-0.045, -0.002]) and 2 h after glucose tolerance test (B = -0.099 [-0.158, -0.039]), but not with HbA1c (B = 0.000 [-0.014, 0.013]), after adjustment for relevant factors. In prospective analyses (n = 257), serum LA was not associated with fasting (B = 0.003 [-0.019, 0.025]) or post-load glucose (B = -0.026 [-0.100, 0.049]). Furthermore, no significant associations were found between serum ALA and glucose metabolism in cross-sectional or prospective analyses. CONCLUSIONS In this study, serum LA was inversely associated with fasting and post-load glucose in cross-sectional, but not in prospective analyses. Further studies are needed to elucidate the exact role of serum LA and ALA levels and dietary polyunsaturated fatty acids in glucose metabolism.
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Affiliation(s)
- Mieke Cabout
- Department of Health Sciences and EMGO Institute for Health and Care Research, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
- Unilever Research and Development, Vlaardingen, The Netherlands.
| | - Marjan Alssema
- Unilever Research and Development, Vlaardingen, The Netherlands
- Department of Epidemiology and Biostatistics and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Giel Nijpels
- Department of General Practice and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Coen D A Stehouwer
- Department of Internal Medicine and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Peter L Zock
- Unilever Research and Development, Vlaardingen, The Netherlands
| | - Ingeborg A Brouwer
- Department of Health Sciences and EMGO Institute for Health and Care Research, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Amany K Elshorbagy
- Institute of Basic Medical Sciences, Department of Nutrition, University of Oslo, Oslo, Norway
| | - Helga Refsum
- Institute of Basic Medical Sciences, Department of Nutrition, University of Oslo, Oslo, Norway
- Department of Pharmacology, University of Oxford, Oxford, UK
| | - Jacqueline M Dekker
- Department of Epidemiology and Biostatistics and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
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17
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van Moorsel D, Henry RM, Schaper NC, van Greevenbroek MM, van Rossum EF, 't Hart LM, Schalkwijk CG, van der Kallen CJ, Dekker JM, Stehouwer CD, Havekes B. BclI Glucocorticoid Receptor Polymorphism in Relation to Arterial Stiffening and Cardiac Structure and Function: The Hoorn and CODAM Studies. Am J Hypertens 2017; 30:286-294. [PMID: 28096152 DOI: 10.1093/ajh/hpw196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 12/15/2016] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Chronic glucocorticoid excess is associated with arterial stiffening and cardiac dysfunction. The BclI glucocorticoid receptor (GR) polymorphism increases GR sensitivity and is associated with a higher body mass index (BMI) and some proxies for cardiovascular disease (CVD). Whether BclI influences arterial stiffening and cardiac dysfunction is currently unknown. Therefore, the aim of the present study was to investigate the association of the BclI polymorphism with arterial stiffening and cardiac structure and function. METHODS We conducted an observational cohort study, combining 2 cohort studies designed to investigate genetic and metabolic determinants of CVD. We genotyped 1,124 individuals (age: 64.7 ± 8.5 years) from the Hoorn study and Cohort on Diabetes and Atherosclerosis Maastricht (CODAM) study for BclI. Several arterial stiffening indices of the carotid (Hoorn and CODAM study), brachial and femoral artery and the carotid-femoral pulse wave velocity (Hoorn study only) were determined. In addition, in the Hoorn study, we determined several variables of cardiac structure and function. RESULTS We identified 155 homozygous carriers (GG), 498 heterozygous carriers (CG), and 471 noncarriers (CC) of the BclI polymorphism. BclI genotypes did not display significant differences in variables of arterial stiffening (e.g., carotid distensibility coefficient (DC): 12.41 ± 5.37 vs. 12.87 ± 5.55 10-3/kPa [mean ± SD]; P = 0.38; homozygous vs. noncarriers). In addition, no clear differences in estimates of cardiac structure and function were found. CONCLUSIONS Even though BclI is associated with a higher BMI and some proxies of CVD, our results do not support the concept that BclI carrier status is associated with greater arterial stiffening or cardiac dysfunction.
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Affiliation(s)
- Dirk van Moorsel
- Department of Internal Medicine, Division of Endocrinology, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Human Biology and Human Movement Sciences, Maastricht University Medical Center, Maastricht, The Netherlands
- NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Ronald M Henry
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
- Heart and Vascular Center, Maastricht University Medical Center, Maastricht, The Netherlands
- CARIM School for Cardiovascular Diseases Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Nicolaas C Schaper
- Department of Internal Medicine, Division of Endocrinology, Maastricht University Medical Center, Maastricht, The Netherlands
- CARIM School for Cardiovascular Diseases Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands
- CAPHRI School for Public Health and Primary Care, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Marleen M van Greevenbroek
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
- CARIM School for Cardiovascular Diseases Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Elisabeth F van Rossum
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Leen M 't Hart
- Department of Molecular Cell Biology, Leiden University Medical Center, Leiden, The Netherlands
- Section Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Casper G Schalkwijk
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
- CARIM School for Cardiovascular Diseases Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Carla J van der Kallen
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
- CARIM School for Cardiovascular Diseases Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jacqueline M Dekker
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Coen D Stehouwer
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
- CARIM School for Cardiovascular Diseases Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Bas Havekes
- Department of Internal Medicine, Division of Endocrinology, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Human Biology and Human Movement Sciences, Maastricht University Medical Center, Maastricht, The Netherlands
- NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
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18
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Bergerot C, Davidsen ES, Amaz C, Thibault H, Altman M, Bellaton A, Moulin P, Derumeaux G, Ernande L. Diastolic function deterioration in type 2 diabetes mellitus: predictive factors over a 3-year follow-up. Eur Heart J Cardiovasc Imaging 2017; 19:67-73. [DOI: 10.1093/ehjci/jew331] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 12/21/2016] [Indexed: 12/11/2022] Open
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19
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Kuznetsova T, Thijs L, Knez J, Cauwenberghs N, Petit T, Gu YM, Zhang Z, Staessen JA. Longitudinal Changes in Left Ventricular Diastolic Function in a General Population. Circ Cardiovasc Imaging 2015; 8:CIRCIMAGING.114.002882. [DOI: 10.1161/circimaging.114.002882] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Tatiana Kuznetsova
- From the Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (T.K., L.T., J.K., N.C., T.P., Y-M.G., Z.Z., J.A.S.)
| | - Lutgarde Thijs
- From the Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (T.K., L.T., J.K., N.C., T.P., Y-M.G., Z.Z., J.A.S.)
| | - Judita Knez
- From the Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (T.K., L.T., J.K., N.C., T.P., Y-M.G., Z.Z., J.A.S.)
| | - Nicholas Cauwenberghs
- From the Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (T.K., L.T., J.K., N.C., T.P., Y-M.G., Z.Z., J.A.S.)
| | - Thibault Petit
- From the Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (T.K., L.T., J.K., N.C., T.P., Y-M.G., Z.Z., J.A.S.)
| | - Yu-Mei Gu
- From the Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (T.K., L.T., J.K., N.C., T.P., Y-M.G., Z.Z., J.A.S.)
| | - Zhenyu Zhang
- From the Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (T.K., L.T., J.K., N.C., T.P., Y-M.G., Z.Z., J.A.S.)
| | - Jan A. Staessen
- From the Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (T.K., L.T., J.K., N.C., T.P., Y-M.G., Z.Z., J.A.S.)
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20
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Maahs DM, Daniels SR, de Ferranti SD, Dichek HL, Flynn J, Goldstein BI, Kelly AS, Nadeau KJ, Martyn-Nemeth P, Osganian SK, Quinn L, Shah AS, Urbina E. Cardiovascular disease risk factors in youth with diabetes mellitus: a scientific statement from the American Heart Association. Circulation 2014; 130:1532-58. [PMID: 25170098 DOI: 10.1161/cir.0000000000000094] [Citation(s) in RCA: 123] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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21
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Catena C, Colussi G, Martinis F, Pezzutto F, Sechi LA. Plasma glucose levels and left ventricular diastolic function in nondiabetic hypertensive patients. Am J Hypertens 2013; 26:1353-61. [PMID: 23846724 DOI: 10.1093/ajh/hpt114] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Changes in left ventricular (LV) diastolic filling anticipate diastolic heart failure and are frequently detected in patients with hypertension or diabetes. We tested the hypothesis that increased fasting and postload glucose levels are associated with diastolic dysfunction as assessed by tissue Doppler imaging (TDI) in hypertensive patients. METHODS In 104 untreated, nondiabetic, hypertensive patients free of cardiovascular complications, we measured glucose and insulin at fast and after an oral glucose load, calculated the Homeostatic Model Assessment (HOMA) index, and performed electrocardiogram (ECG), conventional echocardiography, and TDI. RESULTS Thirty-one patients who had impaired fasting glucose/impaired glucose tolerance had more frequent LV strain at ECG and worse TDI markers of diastolic function than patients with normal plasma glucose but no differences in variables LV mass, LV geometry, systolic function, and early-/late-wave transmitral diastolic velocity. TDI detected diastolic dysfunction in 46 patients who were older and had greater body mass index, blood pressure, fasting and postload glucose, insulin, HOMA index, LV mass, and left atrial diameter than patients with preserved diastolic function. Variables of diastolic function measured at TDI were significantly related with age, body mass index, LV mass, and fasting and postload plasma glucose. Stepwise regression analysis showed that the relationship of markers of diastolic dysfunction with both fasting and postload glucose levels was independent of possible confounders. CONCLUSIONS Initially abnormal fasting and postload glucose levels are associated with more prominent diastolic impairment in uncomplicated hypertensive patients, suggesting that hyperglycemia might increase the risk of diastolic heart failure even in the absence of diabetes.
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Affiliation(s)
- Cristiana Catena
- Hypertension Unit, Division of Internal Medicine, Department of Experimental and Clinical Medical Science, University of Udine, Udine, Italy.
| | - GianLuca Colussi
- Hypertension Unit, Division of Internal Medicine, Department of Experimental and Clinical Medical Science, University of Udine, Udine, Italy
| | - Flavia Martinis
- Hypertension Unit, Division of Internal Medicine, Department of Experimental and Clinical Medical Science, University of Udine, Udine, Italy
| | - Francesca Pezzutto
- Hypertension Unit, Division of Internal Medicine, Department of Experimental and Clinical Medical Science, University of Udine, Udine, Italy
| | - Leonardo A Sechi
- Hypertension Unit, Division of Internal Medicine, Department of Experimental and Clinical Medical Science, University of Udine, Udine, Italy
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22
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Roos CJ, Scholte AJ, Kharagjitsingh AV, Bax JJ, Delgado V. Changes in multidirectional LV strain in asymptomatic patients with type 2 diabetes mellitus: a 2-year follow-up study. Eur Heart J Cardiovasc Imaging 2013; 15:41-7. [PMID: 23793876 DOI: 10.1093/ehjci/jet075] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
AIMS Asymptomatic patients with diabetes mellitus (DM) and normal left ventricular (LV) ejection fraction (EF) may have LV dysfunction as assessed with speckle tracking echocardiography. Whether this subtle LV dysfunction may progress or not over time remains unknown. The present evaluation assessed changes in LV function with two-dimensional (2D) speckle tracking analysis in asymptomatic clinically stable patients with type 2 DM and normal LVEF after 2-year follow-up. METHODS AND RESULTS A total of 112 asymptomatic patients with type 2 DM and normal LVEF (53 ± 10 years, 59% men) were evaluated. Patients remained clinically stable between baseline and follow-up echocardiography. Conventional and 2D speckle tracking echocardiographic measurements were performed. Circumferential strain (CS) and longitudinal strain (LS) were measured to assess systolic function and strain rate during isovolumetric relaxation time (SR IVR) and peak transmitral early diastolic inflow strain rate (SR E) to assess diastolic function. After 2-year follow-up, a significant increase in the LV mass index and significant decrease in the E/A ratio were observed. Left ventricular ejection fraction remained unchanged (59 to 60%, P = 0.4). In contrast, 2D speckle tracking analysis demonstrated a significant impairment in CS (-19.7 ± 4.0 to -18.9 ± 3.8%, P < 0.001), LS (-17.2 ± 2.3 to -16.9 ± 2.7%, P = 0.022), and SR E (from 1.02 ± 0.28 to 0.94 ± 0.25 S(-1), P < 0.001). After adjusting for changes in the LV mass index, only changes in CS and SR E remained significant (P < 0.001 and P = 0.013, respectively). CONCLUSION Asymptomatic patients with type 2 DM and normal LVEF may show mild progression of subclinical LV function assessed with 2D speckle tracking echocardiography. The prognostic implications of these mild changes warrant prospective evaluation.
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Affiliation(s)
- Cornelis J Roos
- Department of Cardiology, Leiden University Medical Center, Postbus 9600, Leiden 2300 RC, the Netherlands
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