Boudina

C. D. Stehouwer

Diamant

From

G. Nijpels

Henry

J. M. Dekker

K. van den Hurk

Klapholz

Lauer

M. Alssema

Nagueh

O. Kamp

R. M. Henry

Stahrenberg

Stritzke

W. J. Paulus

Y. M. Smulders


                  OBJECTIVE
                  To investigate relative contributions of glucose status and arterial stiffness to markers of left ventricular (LV) systolic and diastolic dysfunction after 8 years of follow-up.
               
               
                  RESEARCH DESIGN AND METHODS
                  In the population-based prospective Hoorn Study, 394 individuals with preserved LV systolic and diastolic function participated, of whom 87 had impaired glucose metabolism and 128 had type 2 diabetes. Measurements including arterial ultrasound and echocardiography were performed according to standardized protocols.
               
               
                  RESULTS
                  The presence of type 2 diabetes was associated with more severe LV systolic and diastolic dysfunction 8 years later: LV ejection fraction was 2.98% (95% CI 0.46–5.51) lower, and left atrial (LA) volume index, LV mass index, and tissue Doppler-derived E/e′ were 3.71 mL/m2 (1.20–6.22), 5.86 g/m2.7 (2.94–8.78), and 1.64 units (0.95–2.33) higher, respectively. Furthermore, presence of impaired glucose metabolism or type 2 diabetes was associated with 8-year increases in LV mass index. More arterial stiffness (measured as a lower distensibility) was associated with LV diastolic dysfunction 8 years later: LA volume index, LV mass index, and E/e′ at follow-up were higher. Subsequent adjustments for baseline mean arterial pressure and/or LV diastolic dysfunction did not eliminate these associations. Associations of type 2 diabetes and arterial stiffness with markers of LV diastolic dysfunction were largely independent of each other.
               
               
                  CONCLUSIONS
                  Both glucose status and arterial distensibility are independently associated with more severe LV diastolic dysfunction 8 years later and with deterioration of LV diastolic dysfunction. Therefore, type 2 diabetes and arterial stiffness may relate to LV diastolic dysfunction through different pathways.
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Katja van den Hurk

Marjan Alssema

Otto Kamp

Ronald M. Henry

Coen D. Stehouwer

Yvo M. Smulders

Giel Nijpels

Walter J. Paulus

Jacqueline M. Dekker

Crossref

Diabetes Care

Independent Associations of Glucose Status and Arterial Stiffness With Left Ventricular Diastolic Dysfunction

http://care.diabetesjournals.org/content/diacare/35/6/1258.full.pdf

Independent Associations of Glucose Status and Arterial Stiffness With Left Ventricular Diastolic Dysfunction: An 8-year follow-up of the Hoorn Study

Independent Associations of Glucose Status and Arterial Stiffness With Left Ventricular Diastolic Dysfunction: An 8-year follow-up of the Hoorn Study

Abstract

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