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Fasting plasma glucose is an independent determinant of left ventricular diastolic dysfunction in nondiabetic

Junko Miyazato1, Takeshi Horio, Shuichi Takishita

  • 1Department of Medicine, National Cardiovascular Center, Suita, Japan.

Hypertension Research : Official Journal of the Japanese Society of Hypertension
|July 24, 2002
PubMed

Insights

Mildly elevated fasting plasma glucose (FPG) in hypertensive patients predicts left ventricular (LV) diastolic dysfunction. This impaired glucose metabolism specifically affects cardiac diastolic function, independent of LV hypertrophy.

Area of Science:

  • Cardiology
  • Endocrinology
  • Metabolic Syndrome

Background:

  • Left ventricular (LV) hypertrophy and diastolic dysfunction are common in hypertensive patients.
  • These cardiac changes can be influenced by factors beyond blood pressure, including glucose metabolism.

Purpose of the Study:

  • To investigate the impact of mild glucose metabolism abnormalities on LV structure and function in essential hypertension.
  • To determine if early-stage impaired glucose metabolism affects cardiac diastolic function independently of LV hypertrophy.

Main Methods:

  • Echocardiography (two-dimensional and Doppler) was performed on 193 nondiabetic patients with treated essential hypertension.
  • Calculated parameters included relative wall thickness (RWT), LV mass index (LVMI), fractional shortening, and the ratio of peak atrial filling velocity to early diastolic filling (A/E).
  • Fasting plasma glucose (FPG) and HbA1c levels were assessed and correlated with echocardiographic findings.

Main Results:

  • FPG and HbA1c positively correlated with the A/E ratio and E wave deceleration time, indicating diastolic dysfunction.
  • No correlation was found between glucose levels and RWT, LVMI, or fractional shortening (indicators of hypertrophy).
  • Patients with FPG ≥ 100 mg/dl (<126 mg/dl) showed significantly higher A/E ratios, suggesting worse diastolic function, independent of age, blood pressure, or LV structure.

Conclusions:

  • Fasting plasma glucose (FPG) is a sensitive predictor of left ventricular (LV) diastolic dysfunction in hypertensive patients without diabetes.
  • Mildly elevated glucose levels, even below the diabetic range, can specifically impair cardiac diastolic function.
  • Early detection and management of glucose metabolism abnormalities are crucial for preserving cardiac function in hypertensive individuals.

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