Arnold C T Ng1, Francesca Prevedello2, Giulia Dolci3, Cornelis J Roos4, Roxana Djaberi4, Matteo Bertini4, See Hooi Ewe4, Christine Allman5, Dominic Y Leung5, Nina Ajmone Marsan4, Victoria Delgado4, Jeroen J Bax6. 1. Department of Cardiology, Princess Alexandra Hospital, The University of Queensland, Woolloongabba, Australia; Translational Research Institute, Brisbane, Australia; Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands. 2. Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands; University of Padua, Department of Cardiac, Thoracic and Vascular Sciences, Padova, Italy. 3. Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands; Section of Cardiology, Department of Medicine, University of Verona, Verona, Italy. 4. Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands. 5. Department of Cardiology, Liverpool Hospital, Sydney, Australia. 6. Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: j.j.bax@lumc.nl.
Abstract
BACKGROUND: Diabetes and obesity are both worldwide growing epidemics, and both are independently associated with increased risk for heart failure and death. The aim of this study was to examine the additive detrimental effect of both diabetes and increasing body mass index (BMI) category on left ventricular (LV) myocardial systolic and diastolic function. METHODS: The present retrospective multicenter study included 653 patients (337 with type 2 diabetes and 316 without diabetes) of increasing BMI category. All patients had normal LV ejection fractions. LV myocardial systolic (peak systolic global longitudinal strain and peak systolic global longitudinal strain rate) and diastolic (average mitral annular e' velocity and early diastolic global longitudinal strain rate) function was quantified using echocardiography. RESULTS: Increasing BMI category was associated with progressively more impaired LV myocardial function in patients with diabetes (P < .001). Patients with diabetes had significantly more impaired LV myocardial function for all BMI categories compared with those without diabetes (P < .001). On multivariate analysis, both diabetes and obesity were independently associated with an additive detrimental effect on LV myocardial systolic and diastolic function. However, obesity was associated with greater LV myocardial dysfunction than diabetes. CONCLUSION: Both diabetes and increasing BMI category had an additive detrimental effect on LV myocardial systolic and diastolic function. Furthermore, increasing BMI category was associated with greater LV myocardial dysfunction than diabetes. As they frequently coexist together, future studies on patients with diabetes should also focus on obesity.
BACKGROUND:Diabetes and obesity are both worldwide growing epidemics, and both are independently associated with increased risk for heart failure and death. The aim of this study was to examine the additive detrimental effect of both diabetes and increasing body mass index (BMI) category on left ventricular (LV) myocardial systolic and diastolic function. METHODS: The present retrospective multicenter study included 653 patients (337 with type 2 diabetes and 316 without diabetes) of increasing BMI category. All patients had normal LV ejection fractions. LV myocardial systolic (peak systolic global longitudinal strain and peak systolic global longitudinal strain rate) and diastolic (average mitral annular e' velocity and early diastolic global longitudinal strain rate) function was quantified using echocardiography. RESULTS: Increasing BMI category was associated with progressively more impaired LV myocardial function in patients with diabetes (P < .001). Patients with diabetes had significantly more impaired LV myocardial function for all BMI categories compared with those without diabetes (P < .001). On multivariate analysis, both diabetes and obesity were independently associated with an additive detrimental effect on LV myocardial systolic and diastolic function. However, obesity was associated with greater LV myocardial dysfunction than diabetes. CONCLUSION: Both diabetes and increasing BMI category had an additive detrimental effect on LV myocardial systolic and diastolic function. Furthermore, increasing BMI category was associated with greater LV myocardial dysfunction than diabetes. As they frequently coexist together, future studies on patients with diabetes should also focus on obesity.
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