Abstract 16996: Cardiac Structure and Function Across the Dysglycemia Spectrum in a Contemporary Bi-Ethnic Elderly Population: The Atherosclerosis Risk in Communities (ARIC) Study
Background: Dysglycemia, including pre-diabetes and overt diabetes mellitus (DM), is associated with an increased risk of death and cardiovascular (CV) morbidity including incident HF. Data regarding cardiac structure and function in subjects with dysglycemia without evidence of overt CV disease is inconsistent.
Methods: We assessed measures of cardiac structure and function in 4594 participants (mean age 75±5 yrs; 62% female, 23% African-American) of the ARIC Visit 5 examination (2011-2013) without prevalent coronary heart disease or HF who underwent transthoracic echocardiography. Subjects were grouped across the dysglycemia spectrum as normal, impaired fasting glucose (IFG), or DM based on a medical history, antidiabetic medication use, fasting glucose and HbA1C levels.
Results: IFG and DM were present in 54% and 28% of population, respectively. Subjects with worse dysglycemia category were more likely to be male, African-American, have hypertension, higher BMI and heart rate. In univariate analyses, subjects with DM and IFG demonstrated larger LV size, wall thickness and mass, worse measures of diastolic function and lower right ventricular systolic function. After adjusting for age, race, gender and other established confounders, only LV wall thickness and relative wall thickness were higher in subjects with IFG, whereas frank DM was also associated with higher LV mass, worse diastolic function and lower RV systolic function.
Conclusion: In a large contemporary bi-racial cohort of elderly subjects without prevalent CV disease or HF, both IFG and DM were associated with alterations of cardiac structure, whereas those with DM had demonstrable abnormalities of cardiac function as well. The prognostic implications of these findings need to be investigated further.
- © 2013 by American Heart Association, Inc.