Yang, H and Wang, Y and Negishi, K and Nolan, M and Marwick, TH, Pathophysiological effects of different risk factors for heart failure, Open Heart, 3, (1) Article e000339. ISSN 2053-3624 (2016) [Refereed Article]
Copyright © 2016 by the BMJ Publishing Group Ltd & British Cardiovascular Society Licensed under Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) https://creativecommons.org/licenses/by-nc/4.0/
METHODS: In this cross-sectional study of 521 asymptomatic community-based subjects ≥65 years with ≥1 HF risk factors, 187 participants (36%) had T2DM and hypertension (T2DM+/HTN+), 109 (21%) had T2DM with no hypertension (T2DM+/HTN-) and 72 (14%) had neither T2DM nor hypertension (T2DM-/HTN-). In 153 patients (29%), clinic blood pressure was ≥140/90 mm Hg, defined as active hypertension (T2DM-/HTN+). All underwent a comprehensive echocardiogram, including conventional parameters for systolic and diastolic function as well as global longitudinal strain (GLS), diastolic strain (DS) and DS rate (DSR). A 6 min walk (6MW) test was used to assess functional capacity.
RESULTS: GLS in T2DM-/HTN+ group (-18.9±2.7%) was similar to that in T2DM-/HTN- group (-19.4±2.4%) and greater than T2DM+/HTN- (-18.0±2.8%, p=0.005). DS in T2DM-/HTN- (0.47±0.15%) exceeded that in T2DM-/HTN+ (0.43±0.14%) and T2DM+/HTN- (0.43±0.13%). 6MW distance was preserved in T2DM-/HTN+ (482±85 m) and reduced in T2DM+/HTN- (469±93, p<0.001). Those with T2DM and active hypertension had worst GLS, DS, DSR and shortest 6MW distance (p<0.002). In multivariable analysis, GLS was associated with T2DM but neither active hypertension nor a history of hypertension. Diastolic markers and left ventricular (LV) mass were associated with hypertension and T2DM. Thus, patients with HF risk factors show different functional disturbances according to aetiology.
CONCLUSIONS: Patients with hypertension had relatively less impaired GLS and preserved 6MW distance but more impaired diastolic function.
|Item Type:||Refereed Article|
|Research Division:||Biomedical and Clinical Sciences|
|Research Group:||Cardiovascular medicine and haematology|
|Research Field:||Cardiology (incl. cardiovascular diseases)|
|Objective Group:||Clinical health|
|Objective Field:||Clinical health not elsewhere classified|
|UTAS Author:||Yang, H (Ms Hilda Yang)|
|UTAS Author:||Wang, Y (Ms Ying Wang)|
|UTAS Author:||Negishi, K (Dr Kazuaki Negishi)|
|UTAS Author:||Nolan, M (Mr Mark Nolan)|
|UTAS Author:||Marwick, TH (Professor Tom Marwick)|
|Deposited By:||Menzies Institute for Medical Research|
|Downloads:||152 View Download Statistics|
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