Document Detail


Effect of diabetes and hypertension on left ventricular diastolic function in a high-risk population without evidence of heart disease.
MedLine Citation:
PMID:  20211851     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: To assess the independent and combined effects of diabetes and hypertension on left ventricular (LV) diastolic function in a community-based cohort at high cardiovascular risk.
METHODS AND RESULTS: Two-dimensional echocardiography was performed in 708 subjects from the Cardiac Abnormalities and Brain Lesions (CABL) study. Peak diastolic early (E) and late (A) transmitral flow, and tissue Doppler-derived early mitral annulus velocity (E') were recorded, and E/A and E/E' ratios were calculated. The population was divided into four groups: those without hypertension or diabetes (HT-/DM-), those with only hypertension (HT), only diabetes (DM), and with hypertension plus diabetes (HT + DM). In multivariate analysis, hypertension and diabetes were independent predictors of worse diastolic function. The coexistence of hypertension and diabetes was associated with greater impairment of diastolic function (higher E/E' ratio than HT-/DM-, HT, or DM, all P < 0.05), independent of covariates. The negative, synergistic effect of hypertension and diabetes on LV diastolic function was present both in lean participants and in overweight/obese ones. An E/E' ratio >15, suggestive of increased LV filling pressure, was found in 2.2% of HT-/DM-, 8.9% of HT, 5.9% of DM, and 14.7% of HT + DM (P < 0.01).
CONCLUSION: Hypertension and diabetes are independently associated with impaired LV diastolic function, independent of the effect of overweight/obesity and other covariates. Their coexistence results in a negative synergistic effect on LV diastolic mechanics and is associated with higher LV filling pressures than either condition alone.
Authors:
Cesare Russo; Zhezhen Jin; Shunichi Homma; Tatjana Rundek; Mitchell S V Elkind; Ralph L Sacco; Marco R Di Tullio
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2010-03-07
Journal Detail:
Title:  European journal of heart failure     Volume:  12     ISSN:  1879-0844     ISO Abbreviation:  Eur. J. Heart Fail.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-22     Completed Date:  2011-06-02     Revised Date:  2011-07-28    
Medline Journal Info:
Nlm Unique ID:  100887595     Medline TA:  Eur J Heart Fail     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  454-61     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Department of Medicine, College of Physicians and Surgeons, Columbia University, PH3-342 630 West 168th Street, New York, NY 10032, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Cohort Studies
Confidence Intervals
Diabetes Mellitus / physiopathology*,  ultrasonography
Diastole
Female
Humans
Hypertension / complications*,  ultrasonography
Incidence
Linear Models
Male
Multivariate Analysis
New York City / epidemiology
Prevalence
Risk Assessment
Risk Factors
Statistics as Topic
Statistics, Nonparametric
Ventricular Dysfunction, Left / epidemiology,  ultrasonography*
Ventricular Function, Left*
Grant Support
ID/Acronym/Agency:
NS29993/NS/NINDS NIH HHS; R01 NS36286/NS/NINDS NIH HHS
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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