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Subclinical decrease in cardiac autonomic and diastolic function in patients with metabolic disorders: HSCAA study

Akiko Morimoto1, Manabu Kadoya1, Miki Kakutani-Hatayama1

  • 1Division of Diabetes, Endocrinology and Clinical Immunology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, 663-8501, Japan.

Metabolism Open
|August 20, 2020
PubMed

Insights

Metabolic disorders like diabetes and obesity are linked to reduced cardiac autonomic and diastolic functions, potentially predicting heart failure with preserved ejection fraction (HFpEF). Early detection of autonomic dysfunction may aid in managing pre-heart failure conditions.

Area of Science:

  • Cardiology
  • Metabolic Syndrome
  • Autonomic Nervous System

Background:

  • Heart failure with preserved ejection fraction (HFpEF) is a growing concern, particularly in patients with metabolic disorders.
  • Subclinical cardiac dysfunction often precedes overt HFpEF, highlighting the need for early detection markers.

Purpose of the Study:

  • To investigate the relationship between cardiac autonomic function and diastolic function in individuals with metabolic diseases.
  • To identify potential predictors of diastolic dysfunction in a pre-heart failure population.

Main Methods:

  • The study analyzed 605 patients with metabolic diseases, assessing cardiac autonomic function (e.g., SDNN, HF) and diastolic function (E/A ratio).
  • Statistical analyses were performed to determine associations between metabolic parameters, autonomic function, and diastolic function, controlling for confounders.

Main Results:

  • Glucose intolerance, diabetes, and visceral adiposity were significantly associated with impaired cardiac autonomic and diastolic functions.
  • Higher autonomic function (SDNN, HF) correlated with better diastolic function (E/A), independent of diabetes, BMI, visceral adiposity, and insulin resistance.

Conclusions:

  • Reduced cardiac autonomic function may serve as an early predictor of decreased diastolic function in metabolic disorders.
  • Targeting autonomic dysfunction could be a therapeutic strategy for preventing HFpEF in at-risk populations.

Keywords:
AdiposityCardiac diastolic dysfunctionDiabetesGlucose toleranceHeart rate variabilityInsulin resistanceParasympathetic activityVisceral obesity

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