Abstract 18356: Are Soluble Receptors of Advanced Glycation End Products Associated with Pre-clinical Diastolic Dysfunction in Patients with Diabetes?
Background: Pre-clinical diastolic dysfunction is common in diabetes. The parameter, E/e (ratio of the early mitral inflow (E) to septal mitral annular velocity (e) in diastole) is a continuous variable that correlates with increased LV filling pressure. In retrospective studies in diabetes, an E/e >15 predicted mortality and heart failure (HF). The soluble receptor of advanced glycation end products (sRAGE) and the splice variant, endogenous secretory RAGE (esRAGE) have been proposed as biomarkers of systolic HF in diabetes. This prospective study investigated the relationship between sRAGE, esRAGE and pre-clinical diastolic function in patients with diabetes.
Methods: We recruited 263 patients with diabetes attending for a transthoracic echocardiogram as part of a complications surveillance program. Pre-clinical diastolic dysfunction was defined as an E/e >15. Patients with LVEF <50%, coronary artery disease, history of HF and significant valve pathology were excluded (n =86). Serum levels of sRAGE and esRAGE were measured using an ELISA. Data are presented as mean ±SD for parametric variables and geometric mean (25, 75th quartile) for non-parametric variables.
Results: Patients with an elevated E/e’ were significantly older (69 ±10 vs. 59 ±13y, p <0.001) and were more likely to have hypertension (97 vs. 75%, p = 0.002) and a reduced eGFR <60ml/min/1.73m2 (47 vs. 14%, p <0.001). Gender, HbA1c and other cardiac risk factors were similar. Levels of sRAGE and esRAGE (geometric mean (25, 75th quartile) are shown below. Serum sRAGE remained significantly associated with an elevated E/e’ after adjustment for age, gender, BMI, diabetes duration, hypertension and renal function (p=0.015).
Conclusions: Serum levels of sRAGE but not esRAGE are associated with pre-clinical diastolic function assessed in patients with diabetes. Follow up studies are underway to assess if an elevated sRAGE predicts the development of overt HF in this cohort of patients with diabetes.
- © 2012 by American Heart Association, Inc.