Abstract 545: Effect of Diabetes and Hypertension on Left Ventricular Diastolic Function in a Community-Based Cohort
Background: Left ventricular (LV) diastolic dysfunction is associated with future occurrence of heart failure and is often observed in patients with diabetes mellitus (DM) and arterial hypertension (HT). We sought to assess the independent and combined effects of DM and HT on LV diastolic function in a community-based cohort.
Methods: Two-dimensional echocardiography was performed in 589 subjects from the NINDS-funded Cardiac Abnormalities and Brain Lesions (CABL) study. Coronary artery disease and LV ejection fraction <50% were exclusion criteria. Transmitral early (E) and late (A) components of diastolic flow, and early mitral annulus excursion (E′) velocity were recorded and E/A and E/E′ ratios were calculated. To assess the separate and combined effect of HT and DM on diastolic function, we divided the population in 4 groups: no HT or DM (reference), HT only, DM only, and HT+DM.
Results: Mean age of the study population was 69.8±9.8 years; 65.2% were women. Prevalence of HT and DM was 69.3% and 28.9%, respectively. In multivariate analysis adjusted for age, BMI, sex, LV mass, relative wall thickness, EF and heart rate, the HT group had significantly lower E′ and higher E/E′ than the reference group (Table⇓). The HT+DM group had a more severely impaired diastolic function compared to the other groups. In particular, the HT+DM group showed higher E/E′ ratio than the reference, the HT or the DM groups. An E/E′ ratio >15, suggestive of increased LV filling pressure, was found in 2.7% of the reference group, 7.3% of HT, 6.7% of DM and 13.1% of HT+DM (overall p<0.01).
Conclusions: HT and DM are independently associated with worse LV diastolic function. The coexistence of HT and DM has a synergistic effect in impairing the diastolic function, and is associated with higher LV filling pressures than either condition alone.