Impact of diabetes on left ventricular diastolic function in patients with arterial hypertension

Abstract

Aims: To analyse the effect of diabetes (DM) on diastolic function in hypertensive patients. Methods: 439 hypertensive patients were selected for participation in this study. All participants had an echocardiographic evaluation of systolic and diastolic function. The overall degree of diastolic function and specific parameters (e.g. E/Ea ratio) were analysed. Results: We divided the cohort (63 10 years) into those with diabetes mellitus (DM(+), n = 124) and without diabetes mellitus (DM(-), n = 315). The prevalence of normal diastolic function was lower in DM(+) than DM(-) (19.4% vs. 30.8%); mild (65.3% vs. 60.0%) and moderate/severe diastolic dysfunction were more frequent in DM(+) (15.3% vs. 9.2%, p = 0.022). The E/Ea ratio, an estimate of left ventricular end-diastolic pressure, was significantly higher in DM(+) (12.3 +/- 4.4) as compared to DM(-) (10.8 +/- 3.6, p < 0.001). Sex-specific analysis revealed that the effect of DM on diastolic function was mainly limited to the male subgroup. Multivariate logistic regression analysis showed that diabetes affected diastolic function in males independent of blood pressure, left ventricular mass index, concomitant medication and prevalence of coronary artery disease. Conclusion: Diabetes negatively affects diastolic function in patients with arterial hypertension. This effect is mainly confined to the male subgroup. (C) 2007 European Society of Cardiology. Published by Elsevier B.V All rights reserved.