کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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5967408 | 1576170 | 2015 | 7 صفحه PDF | دانلود رایگان |
BackgroundThe alarming prevalence of heart failure with preserved ejection fraction requires quantification of diastolic dysfunction (DDF). Myocardial diastolic velocity Eâ² implies that age is the most important determinant. We tested the hypothesis that age allows for quantification of DDF and assessment of the structural and metabolic determinants in patients with and without type 2 diabetes (D).MethodsThis prospective, cross-sectional study assessed cardiovascular, metabolic and ultrasound data in 409 consecutive patients (Diabetes Center, Bogenhausen-Munich) between 20 and 90 years without known cardiac disease and either with (n = 204) or without D but with common prevalence of cardiovascular risk factors, including a subgroup of healthy individuals (H, n = 94).ResultsIn H, Eâ² related to age as: Eâ²norm = â 0.163 â years + 19.69 (R2 = 0.77, p < 0.0001). According to this 1% reduction by annual physiologic aging, DDF was quantitated as Eâ²Â â Eâ² norm. Compared to nondiabetics, D patients were older, had greater BMI, lower Eâ², more cardiovascular risk and greater DDF. In nondiabetics, grading of DDF by E â Eâ²norm correlated with grading by filling pressure E/Eâ². Determinants of DDF by multivariate analysis included pulse wave velocity, diastolic blood pressure and the triglyceride/HDL ratio (a marker of insulin resistance) in nondiabetics and in D the same risk factors in reverse sequence and heart rate. Neither left atrial size nor left ventricular mass had significant impact.ConclusionsThe physiological impact of age on myocardial function consists of a 1% annual reduction in Eâ² and enables precise quantification of diastolic dysfunction thereby unmasking the importance of metabolic risk for DDF.
Journal: International Journal of Cardiology - Volume 182, 1 March 2015, Pages 368-374