Effect of diabetes and hypertension on left ventricular diastolic function in a high-risk population without evidence of heart disease

Cesare Russo, Zhezhen Jin, Shunichi Homma, Tatjana Rundek, Mitchell S V Elkind, Ralph L Sacco, Marco R. Di Tullio

Research output: Contribution to journalArticle

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Abstract

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/E0 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.

Original languageEnglish
Pages (from-to)454-461
Number of pages8
JournalEuropean Journal of Heart Failure
Volume12
Issue number5
DOIs
StatePublished - May 1 2010

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Left Ventricular Function
Heart Diseases
Hypertension
Population
Ventricular Pressure
Mechanics
Echocardiography
Multivariate Analysis
Obesity

Keywords

  • Diabetes
  • Diastolic function
  • Echocardiography
  • Hypertension
  • Tissue Doppler

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

Cite this

Effect of diabetes and hypertension on left ventricular diastolic function in a high-risk population without evidence of heart disease. / Russo, Cesare; Jin, Zhezhen; Homma, Shunichi; Rundek, Tatjana; Elkind, Mitchell S V; Sacco, Ralph L; Di Tullio, Marco R.

In: European Journal of Heart Failure, Vol. 12, No. 5, 01.05.2010, p. 454-461.

Research output: Contribution to journalArticle

Russo, Cesare ; Jin, Zhezhen ; Homma, Shunichi ; Rundek, Tatjana ; Elkind, Mitchell S V ; Sacco, Ralph L ; Di Tullio, Marco R. / Effect of diabetes and hypertension on left ventricular diastolic function in a high-risk population without evidence of heart disease. In: European Journal of Heart Failure. 2010 ; Vol. 12, No. 5. pp. 454-461.
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AU - Jin, Zhezhen

AU - Homma, Shunichi

AU - Rundek, Tatjana

AU - Elkind, Mitchell S V

AU - Sacco, Ralph L

AU - Di Tullio, Marco R.

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N2 - 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/E0 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.

AB - 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/E0 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.

KW - Diabetes

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KW - Echocardiography

KW - Hypertension

KW - Tissue Doppler

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