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Impact of type 2 diabetes on left ventricular geometry and diastolic function in hypertensive patients with chronic

E Nardi1, A Palermo, G Mulè

  • 1Cattedra di Medicina Interna, Dipartimento di Medicina Interna, Malattie Cardiovascolari e NefroUrologiche, Excellence Centre of the European Society of Hypertension, Università degli Studi di Palermo, Palermo, Italy. emilionardi@virgilio.it

Journal of Human Hypertension
|October 15, 2010
PubMed

Insights

Type 2 diabetes significantly worsens left ventricular hypertrophy (LVH) and diastolic dysfunction in hypertensive patients with chronic kidney disease (CKD). Diabetes is linked to thicker heart walls and poorer diastolic function, independent of other factors.

Area of Science:

  • Cardiology
  • Nephrology
  • Endocrinology

Background:

  • Left ventricular hypertrophy (LVH) and diastolic dysfunction are prevalent in chronic kidney disease (CKD).
  • The impact of type 2 diabetes on cardiac structure and function in CKD patients requires further elucidation.
  • Hypertension is a common comorbidity in CKD, influencing cardiovascular outcomes.

Purpose of the Study:

  • To assess the effect of type 2 diabetes on left ventricular (LV) geometry and diastolic function.
  • To investigate the association between diabetes, LVH, and diastolic dysfunction in hypertensive CKD patients.
  • To identify independent predictors of diastolic dysfunction in this patient cohort.

Main Methods:

  • A study involving 288 Caucasian hypertensive CKD patients, with 112 having type 2 diabetes.
  • Exclusion criteria included cardiovascular disease, GFR >60 ml/min/1.73m², dialysis, and major non-CV diseases.
  • Echocardiography with tissue Doppler imaging (TDI) and biochemical analyses were performed.

Main Results:

  • Diabetic patients exhibited significantly increased LV wall thicknesses, relative wall thickness (RWT), and left atrium volume index.
  • A higher prevalence of concentric LVH was observed in diabetic patients.
  • Early diastolic filling (Em) measured by TDI was significantly lower in diabetic patients, an association independent of confounders.

Conclusions:

  • Type 2 diabetes is associated with increased LV wall thickness and concentric geometry in hypertensive CKD patients.
  • Diabetes, along with renal function (GFR), independently predicts worse diastolic function in this population.
  • These findings highlight the detrimental cardiovascular impact of diabetes in CKD patients.

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