Triglyceride-glucose index and subclinical left ventricular dysfunction across cardiovascular-kidney-metabolic
Kun-Zhe Tsai1,2, Gen-Min Lin3,4, Chunho Yun5
1Department of Stomatology of Periodontology, Mackay Memorial Hospital, Taipei, Taiwan.
Background:
The triglyceride-glucose (TyG) index is associated with cardiovascular disease risk, but its role in identifying subclinical myocardial dysfunction and predicting heart failure (HF) in asymptomatic adults remains unclear.
Objectives:
To assess the association between TyG index and left ventricular global longitudinal strain (GLS), define a threshold for subclinical left ventricular dysfunction (SLVD), and evaluate its link to incident HF hospitalization.
Methods:
In this retrospective cohort study included, 4,784 asymptomatic adults aged 18-86 years from a Taiwan community and health check-up cohort without lipid-lowering therapy were included. SLVD was defined as GLS ≥-18%. Multivariable logistic and Cox regression analyses examined the relationship between TyG index, SLVD, and HF risk with covariates adjustment.
Results:
A TyG index ≥8.64 optimally discriminated individuals with SLVD, with an area under the receiver operating characteristic curve of 0.70. The prevalence of SLVD was 4.9% (130/2,656) among those with a normal TyG index and 12.9% (268/2,067) among those with an elevated TyG index. An elevated TyG index was independently associated with SLVD [odds ratio 1.62; 95% confidence interval (CI): 1.25-2.09], with stronger associations in those with stage B HF or cardiovascular-kidney-metabolic (CKM) syndrome. The proportion of individuals with an elevated TyG index increased markedly across CKM stages, from 3.5% (23/665) at stage 0 to 14.9% (148/991) at stage 1, 62.6% (1,849/2,955) at stage 2, and 42.0% (47/112) at stage 3. Over a median follow-up of 7.43 years, 61 participants experienced HF hospitalization. Individuals with both SLVD and a high TyG index had a substantially higher risk of HF hospitalization (hazard ratio 7.26; 95% CI: 3.44-15.35) compared with those without either condition.
Conclusions:
TyG index is a simple, accessible marker for early myocardial dysfunction and future HF risk, particularly when combined with SLVD or early-stage HF.
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