Abstract 14565: Obesity and Type 2 Diabetes Has Additive Detrimental Effects on Left Ventricular Myocardial Function
Background: Both obesity and diabetes are independently associated with increased risk for heart failure. However, obesity and diabetic cardiomyopathies have different underlying etiologies. The present study aims to examine the impact of increasing obesity as determined by body mass index (BMI) on left ventricular (LV) myocardial function in type 2 diabetic patients.
Methods: A total of 337 type 2 diabetic patients were categorized into lean (n = 80; BMI< 25 kg/m2), overweight diabetics (n = 139, BMI 25 — 29.9 kg/m2) and obese diabetics (n = 118, BMI ≥ 30kg/m2). Diabetic patients were compared against 316 non-diabetics matched to age, gender and BMI (89 lean, 134 and 93 obese non-diabetics). All patients had normal segmental wall motion, preserved LV ejection fraction (EF, > 50%) and normal valvular functions. Myocardial function was quantified by global longitudinal strain (GLS) using 2-dimensional speckle tracking echocardiography.
Results: Mean age was 57 ± 12 years, 63.2% men. Increasing BMI was associated with progressive increases in LV end-diastolic (p = 0.02) and end-systolic (p = 0.048) volumes and LV mass (p < 0.001), but no changes in LVEF (p = 0.53) in the diabetic patients. However, GLS progressively declined with increasing BMI (p < 0.001). Compared to the matched non-diabetic patients, diabetic patients had similar LV volumes, EF and mass, but had more impaired GLS (p < 0.001). Figure 1 showed that diabetic patients had more impaired GLS across all BMI categories. Multivariate analysis showed that BMI (β = 0.379, p < 0.001) and diabetes (β = 0.231, p < 0.001) were independently associated with impaired GLS. There was no interaction between BMI and diabetes.
Conclusion: Obesity and diabetes had additive detrimental effects on LV myocardial function. Furthermore, obesity had a greater impact on LV myocardial dysfunction than diabetes.
- © 2010 by American Heart Association, Inc.