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LV systolic impairment in patients with asymptomatic coronary heart disease and type 1 diabetes is related to coronary atherosclerosis, glycaemic control and advanced glycation endproducts
Author(s) -
Steine Kjetil,
Larsen Jakob R.,
Stugaard Marie,
Berg Tore Julsrud,
Brekke Magne,
DahlJørgensen Knut
Publication year - 2007
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2007.07.013
Subject(s) - medicine , cardiology , diabetes mellitus , asymptomatic , heart failure , type 2 diabetes , coronary atherosclerosis , coronary heart disease , endocrinology
Aims: To evaluate whether heart failure in type 1 diabetes is linked to poor glycaemic control, coronary atherosclerosis or advanced glycation endproducts (AGEs). Methods: Twenty six patients with type 1 diabetes (mean duration 32±5years), and 16 age matched controls were recruited. Mean HbA 1c through 18years (HbA 1c 18), serum levels of AGEs and coronary atherosclerotic burden (CAB) were determined by IVUS. Peak tissue velocities and strain by tissue Doppler imaging were measured in 12 LV regions as an evaluation of LV function. Results: Systolic tissue velocity was inversely correlated to CAB ( r =0.53, p <0.01), to HbA 1c 18 ( r =0.46, p <0.05) and to the duration of diabetes ( r =0.46, p <0.05). Systolic strain was inversely correlated to HbA 1c 18 ( r =0.45, p <0.05), to duration of diabetes ( r =0.41, p <0.05), and tended to correlate with AGEs ( r =0.37, p =0.07). In multiple regression analyses, CAB and HbA 1c 18 were significant independent predictors for systolic velocity, while AGEs and duration of diabetes were significant predictors of systolic strain. Conclusion: LV systolic function was impaired by increasing coronary atherosclerosis and worsening of glycaemic control. AGEs might be another mechanism for the increased risk of heart failure in type 1 diabetes.