Abstract 3045: Tissue Advanced Glycation End-products Are Associated With Diastolic Dysfunction and Aerobic Exercise Capacity in Diabetic Patients With Heart Failure
Introduction: Advanced glycation endproducts (AGEs) are increased in patients with diabetes, and can result in diastolic dysfunction through the formation of collagen crosslinks in the heart. The relation between tissue AGEs, the severity of diastolic and systolic dysfunction and aerobic exercise capacity measured with VO2-max was studied in a population of patients with systolic chronic heart failure (CHF) with and without diabetes. The aim of this study was to determine the relation between tissue AGEs, diastolic function and aerobic exercise capacity.
Methods: 204 patients with CHF were included. Tissue AGEs were measured with a validated skin-autofluorescence measurement. Echocardiographic diastolic function was expressed as early mitral valve inflow (E) divided by early tissue velocity (E′) measured with color-coded tissue Doppler and as mean E′ measured on the septal, lateral, inferior and anterior wall areas. Aerobic capacity was measured with cardiopulmonary exercise testing (VO2-max).
Results: Diastolic function and VO2-max were significantly reduced in patients with heart failure and diabetes. There was no difference in left ventricular ejection fraction (LVEF), left ventricular end-diastolic and systolic diameter (LVEDD and LVESD) between 49 patients with CHF and diabetes and 155 patients with CHF without diabetes (see table⇓). Tissue AGE levels correlated both with diastolic function (r=−0.30; p<0.001, after adjusting for age r=−0.19 p=0.01) and VO2-max (r=−0.38; p<0.001, after adjusting for age r=−0.30, p<0.001).
Conclusion: Increased tissue AGEs might explain the impaired diastolic function and exercise capacity that was observed in patients with diabetes and heart failure.