Abstract P137: Effect of Obesity & T2DM on Cardiac Strain in Youth
Introduction: Heart failure is a complication of long standing T2DM. Advanced echo measures can identify early sub-clinical systolic dysfunction in adults with T2DM. We hypothesized that subtle systolic dysfunction was present in young diabetics.
Methods: Longitudinal strain was measured in 151 subjects with T2DM matched by age, race and sex to a lean (L=146), and non-diabetic (proven by OGTT) obese (O=162) control (23.0 ± 4.0 years, 35% male, 63% African American). Anthropometrics, BP, HR, fasting lipids, glucose and CRP and echocardiograms for LVM, shortening fraction (SF), global longitudinal 4-chamber strain (GLS) and strain rate in systole (GLSR) were obtained. ANOVA was performed to compare differences among groups for CV risk factors and strain measures and ANCOVA to determine if presence of T2DM remained an independent predictor of strain after correction for risk factors (full model=age, sex, race, presence of T2DM, BMI, SBP, DBP, HR and lab values).
Results: CV risk factors worsened and there was a graded decline in GLS from L to O to T2DM subjects. GLSR was less negative and LVM/ht2.7 was higher in O & T as compared to L (all p < 0.05). There was no difference in SF among groups. Presence of T2DM was an independent determinant of GLS and GLSR adjusted for most CV risk factors but lost significance when BMI was added to the model. GLS = -21.6 -age*0.088 - male*1.8 + 0.12*BMI + 0.045*DBP + 0.058*HR - 0.023*HDL (R2 = 0.38, p<0.0001); GLSR = -1.20 -male*0.093 + WHR*0.48 + DBP*0.0029 (R2 = 0.23, p<0.0001).
Conclusion: Early in the course of T2D in youth, obesity has a greater deleterious effect on systolic function than T2DM. Treatment of obesity in youth is necessary for prevention of future heart failure.
Author Disclosures: J.E. Haley: None. Z. Gao:None. P. Khoury: None. S.N. Stewart: None. N.L. Madsen: None. T.R. Kimball: B. Research Grant; Modest; NIH. L.M. Dolan: B. Research Grant; Modest; NIH. E.M. Urbina: B. Research Grant; Modest; AtCor Medical (travel grant). B. Research Grant; Significant; NIH.
- © 2017 by American Heart Association, Inc.