Background
Methods
Study population
Laboratory analyses
Echocardiography
Statistical analysis
Results
Patients n = 384 | Controls n = 184 | p | |
---|---|---|---|
Demographic data | |||
Age, years | 61 (5) | 64 (9) | < 0.001 |
Female, n (%) | 113 (29) | 91 (49) | < 0.001 |
Smoker or former smoker, n (%) | 257 (67) | 91 (49) | < 0.001 |
Height, cm | 174 (12) | 172 (14) | ns |
Weight, kg | 90 (19) | 76 (21) | < 0.001 |
BMI, kg/m2 | 30 (6) | 26 (5) | < 0.001 |
Medical history | |||
Diabetes duration, years | 6 (7) | 0 | na |
Angina pectoris, n (%) | 30 (8) | 3 (2) | < 0.01 |
Myocardial infarction, n (%) | 24 (6) | 5 (3) | ns |
Coronary revascularization, n (%) | 25 (6) | 4 (2) | < 0.05 |
Heart failure, n (%) | 8 (2) | 0 | na |
Hypertension, n (%) | 253 (66) | 43 (23) | < 0.001 |
Medication | |||
Loop diuretics, n (%) | 26 (7) | 0 | na |
Statins, n (%) | 230 (60) | 19 (10) | < 0.001 |
ACEI and/or ARB, n (%) | 187 (49) | 21 (11) | < 0.001 |
Calcium channel blocker, n (%) | 68 (18) | 9 (6) | < 0.001 |
β-Blocker, n (%) | 138 (36) | 25 (14) | < 0.001 |
Laboratory analyses | |||
HbA1c, % | 5.8 (1.3) | na | |
Triglycerides, mmol/L | 1.5 (1.0) | 1.1 (0.8) | < 0.001 |
Triglycerides, mg/dL | 133 (88) | 97 (71) | < 0.001 |
LDL-C, mmol/L | 2.5 (0.9) | 3.5 (1.0) | < 0.001 |
LDL-C, mg/dL | 96 (35) | 135 (39) | < 0.001 |
Microalbuminuria, n (%) | 60 (16) | 7 (4) | < 0.001 |
Creatinine, µmol/L | 88 (23) | 77 (20) | < 0.001 |
Creatinine, mg/dL | 1.00 (0.26) | 0.87 (0.23) | < 0.001 |
GFR, mL/min/1.73 m2 | 70 (20) | 76 (18) | < 0.001 |
Blood pressure (mmHg) | |||
Systolic blood pressure | 137 (20) | 128 (30) | < 0.001 |
Diastolic blood pressure | 78 (12) | 74 (15) | < 0.001 |
Patients, n | Patients baseline | Patients follow-up | p-value Patients baseline vs. follow-up | Controls, n | Controls baseline | p-value Patients baseline vs. controls | |
---|---|---|---|---|---|---|---|
LA, mm/m2 | 380 | 20.4 (3.1) | 20.6 (3.1) | ns | 183 | 20.8 (4.0) | ns |
LVEDV, mL/m2 | 371 | 46.1 (13.1) | 46.5 (12.0) | < 0.05 | 180 | 48.8 (11.3) | < 0.01 |
LV mass, g/m2 | 324 | 101.8 (30.3) | 101.7 (26.9) | ns | 174 | 94.5 (29.9) | < 0.001 |
LVEF, % | 370 | 52.0 (10.5) | 53.0 (11.0) | ns | 180 | 57.0 (9.0) | < 0.001 |
MAPSE, mm | 370 | 12.0 (2.0) | 12.0 (2.0) | ns | 184 | 12.3 (2.3) | ns |
E/é | 378 | 11.9 (4.5) | 13.3 (4.9) | < 0.001 | 183 | 10.3 (4.1) | < 0.001 |
Explanatory variable | LV mass | LVEF | GLS | E/é | ||||
---|---|---|---|---|---|---|---|---|
Univariable | Multivariable model R2 = 0.23 | Univariable | Multivariable model R2 = 0.19 | Univariable | Multivariable model R2 = 0.24 | Univariable | Multivariable model R2 = 0.18 | |
β1, R2 |
B
| β1, R2 |
B
| β1, R2 |
B
| β1, R2 |
B
| |
Demographic data | ||||||||
Age, years | 0.4, 0.00 | 0.08, 0.00 | − 0.02, 0.00 | 0.14*, 0.02 | ||||
Gender = female | − 12.8***, 0.06 | − 8.1** | − 0.04, 0.00 | − 0.91**, 0.03 | − 0.8* | 1.08**, 0.02 | 1.4*** | |
Smoker/former smoker | 4.2, 0.01 | − 0.8, 0.00 | − 0.27, 0.00 | − 0.30, 0.00 | ||||
BMI, kg/m2 | 1.1***, 0.05 | 1.1*** | − 0.7***, 0.16 | − 0.7*** | 0.17***, 0.10 | 0.2*** | 0.13**, 0.03 | |
Medical history | ||||||||
Diabetes duration, years | − 0.1, 0.00 | 0.09, 0.00 | − 0.01, 0.00 | 0.05, 0.00 | ||||
Angina pectoris | 17.9***,0.04 | − 4.6**, 0.02 | 2.7***, 0.00 | 1.6*** | 1.22, 0.01 | |||
Myocardial infarction | 13.2*, 0.02 | − 3.3, 0.01 | 1.7**, 0.02 | 0.74, 0.00 | ||||
Coronary revascularization | 16.2**, 0.02 | − 3.0, 0.01 | 1.67**, 0.03 | − 0.37, 0.00 | ||||
Heart failure | 20.8*, 0.01 | − 12.2***, 0.05 | − 9.6*** | 4.3***, 0.05 | 2.5** | 4.05**, 0.03 | ||
Hypertension | 3.8, 0.01 | 1.6, 0.01 | − 0.13, 0.00 | 0.60, 0.01 | ||||
Medication | ||||||||
Loop diuretics | 6.8, 0.00 | − 5.8***, 0.03 | 1.9**, 0.03 | 2.7***, 0.04 | 2.1** | |||
Statins | − 3.3, 0.00 | − 0.59, 0.00 | 0.26, 0.00 | 0.28, 0.00 | ||||
ACEI and/or ARB | 4.2, 0.01 | 0.38, 0.00 | 0.00, 0.00 | 0.60, 0.01 | ||||
Calcium channel blocker | 12.9***, 0.04 | 6.6* | − 0.24, 0.00 | 0.27, 0.00 | 0.95*, 0.01 | |||
β-Blocker | 12.8***, 0.06 | 9.4*** | 0.33, 0.00 | − 0.01, 0.00 | 1.02**, 0.02 | 0.8 | ||
Laboratory analyses | ||||||||
HbA1c, % | 0.9, 0.00 | − 1.2**, 0.02 | 0.55***, 0.04 | 0.4** | 0.33, 0.01 | |||
Triglycerides, mmol/L | 1.2, 0.00 | − 1.4*, 0.01 | 0.43*, 0.01 | 0.38*, 0.01 | 0.4* | |||
LDL-C, mmol/L | − 1.2, 0.00 | − 0.32, 0.00 | − 0.05, 0.00 | − 0.15, 0.00 | ||||
Microalbuminuria | 14.8***, 0.05 | 8.4** | − 1.8, 0.01 | 0.49, 0.00 | 1.55**, 0.03 | 1.1* | ||
Creatinine, µmol/L | 0.3***, 0.04 | 0.2* | 0.02, 0.00 | 0.01, 0.00 | 0.00, 0.00 | |||
GFR, mL/min/1.73 m2 | − 0.1, 0.00 | − 0.03, 0.00 | 0.00, 0.00 | − 0.01, 0.00 | ||||
Blood pressure (mmHg) | ||||||||
Systolic blood pressure | 0.3***, 0.03 | 0.2* | − 0.02, 0.00 | 0.02**, 0.02 | 0.06***, 0.07 | 0.06*** | ||
Diastolic blood pressure | 0.2, 0.01 | − 0.05, 0.00 | 0.06***, 0.03 | 0.04** | 0.04*, 0.01 |
Explanatory variable | LV mass | LVEF | GLS | E/é | ||||
---|---|---|---|---|---|---|---|---|
Univariable | Multivariable model R2 = 0.19 | Univariable | Multivariable model R2 = 0.09 | Univariable | Multivariable model R2 = 0.16 | Univariable | Multivariable model R2 = 0.22 | |
β1, R2 |
B
| β1, R2 |
B
| β1, R2 |
B
| β1, R2 |
B
| |
Demographic data | ||||||||
Age, years | 0.4, 0.01 | − 0.03, 0.00 | 0.02, 0.00 | 0.21***, 0.12 | 0.2*** | |||
Gender = female | − 15.0***, 0.11 | − 10.9** | 1.9, 0.02 | − 1.5**, 0.05 | − 1.0 | 0.5, 0.00 | 1.5** | |
Smoker/former smoker | 2.1, 0.00 | − 0.03, 0.00 | 0.38, 0.01 | 0.20, 0.00 | ||||
BMI, kg/m2 | 0.8, 0.21 | − 0.56***, 0.08 | − 0.6*** | 0.27***, 0.01 | 0.2*** | 0.26***, 0.08 | ||
Medical history | ||||||||
Angina pectoris | 2.9, 0.00 | − 1.0, 0.00 | − 0.85, 0.00 | 3.2, 0.02 | ||||
Myocardial infarction | 11.4, 0.01 | − 2.0, 0.00 | 1.2, 0.00 | − 0.46, 0.00 | ||||
Coronary revascularization | 10.1, 0.00 | 0.8, 0.00 | − 0.49, 0.00 | − 3.3*, 0.02 | ||||
Hypertension | 10.4*, 0.04 | − 1.9, 0.01 | 0.86, 0.01 | 0.50, 0.00 | ||||
Medication | ||||||||
Statins | 12.6*, 0.03 | 12.9* | − 3.3, 0.02 | 1.1, 0.01 | − 0.02, 0.00 | |||
ACEI and/or ARB | 8.3, 0.02 | − 2.2, 0.01 | 1.2, 0.01 | − 0.44, 0.00 | ||||
Calcium channel blocker | 15.6*, 0.03 | 0.5, 0.00 | − 0.81, 0.00 | 0.53, 0.00 | ||||
β-Blocker | 5.6, 0.01 | − 1.0, 0.00 | 0.55, 0.00 | 0.13, 0.00 | ||||
Laboratory analyses | ||||||||
Triglycerides, mmol/L | 0.9, 0.00 | 0.06, 0.00 | 0.01*, 0.00 | − 13, 0.00 | ||||
LDL-C, mmol/L | − 1.9, 0.00 | 0.34, 0.00 | 0.36, 0.01 | 0.40, 0.01 | ||||
Microalbuminuria | 10.5, 0.01 | − 14.8, 0.00 | 11.3, 0.00 | 3.5*, 0.04 | ||||
Creatinine, µmol/L | 0.3*, 0.03 | − 0.08, 0.00 | 0.09, 0.02 | 0.05, 0.01 | ||||
GFR, mL/min/1.73 m2 | 0.1, 0.00 | 0.04, 0.01 | 0.00, 0.00 | − 0.03, 0.02 | ||||
Blood pressure (mmHg) | ||||||||
Systolic blood pressure | 0.4***, 0.09 | 0.3** | − 0.03, 0.01 | 0.02, 0.01 | 0.06***, 0.09 | |||
Diastolic blood pressure | 0.6**, 0.08 | − 0.1, 0.02 | 0.08***, 0.07 | 0.2** | 0.10***, 0.08 | 0.1*** |
I | II | III | Significance between groups, p < 0.05 | |
---|---|---|---|---|
Normal weight | Overweight | Obesity | ||
BMI < 25.0 kg/m2 | BMI 25.0–29.9 kg/m2 | BMI ≥ 30.0 kg/m2 | ||
Patients, n = 48 | Patients, n = 163 | Patients, n = 173 | ||
Controls, n = 73 | Controls, n = 84 | Controls, n = 27 | ||
Demographic data | ||||
Age, years | ||||
Patients | 60.5 (2.8) | 60.8 (3.1) | 60.7 (3.1) | ns |
Controls | 62.9 (5.8) | 63.8 (5.7) | 64.5 (5.8) | ns |
Female, n (%) | ||||
Patients | 15 (31.2) | 39 (23.9) | 59 (34.1) | II–III |
Controls | 44 (60.3) | 36 (42.8) | 11 (40.7) | I–II |
Medical history | ||||
Diabetes duration, years | ||||
Patients | 6.4 (5.8) | 6.4 (5.4) | 6.8 (5.2) | ns |
Controls | 0 | 0 | 0 | ns |
Angina, n (%) | ||||
Patients | 4 (8.3) | 10 (6.1) | 25 (14.4) | II–III |
Controls | 0 | 3 (3.6) | 0 | ns |
Myocardial infarction, n (%) | ||||
Patients | 3 (6.2) | 9 (5.5) | 12 (6.9) | ns |
Controls | 1 (1.4) | 2 (2.4) | 2 (7.4) | ns |
Coronary revascularization, n (%) | ||||
Patients | 2 (4.2) | 10 (6.1) | 13 (7.5) | ns |
Controls | 1 (1.4) | 1 (1.2) | 2 (7.4) | ns |
Heart failure, n (%) | ||||
Patients | 1 (2.1) | 1 (0.6) | 6 (3.5) | ns |
Controls | 0 | 0 | 0 | ns |
Hypertension, n (%) | ||||
Patients | 31 (64.6) | 101 (62.0) | 112 (64.7) | ns |
Controls | 12 (16.4) | 21 (25.0) | 10 (37.0) | I–III |
Laboratory analyses | ||||
HbA1c, % | ||||
Patients | 5.5 (0.9) | 6.0 (1.0) | 6.1 (1.0) | I–II, I–III |
Triglycerides, mmol/L | ||||
Patients | 1.2 (0.6) | 1.7 (0.9) | 1.9 (0.9) | I–II, I–III |
Controls | 1.3 (1.6) | 1.4 (0.6) | 1.6 (0.9) | ns |
Triglycerides, mg/dL | ||||
Patients | 106.2 (53.1) | 150.4 (79.6) | 168.1 (79.6) | I–II, I–III |
Controls | 115.0 (141.6) | 123.9 (53.1) | 141.6 (79.7) | ns |
LDL-C, mmol/L | ||||
Patients | 2.7 (0.7) | 2.7 (0.8) | 2.5 (0.6) | ns |
Controls | 3.5 (0.8) | 3.4 (0.9) | 3.5 (1.0) | ns |
LDL-C, mg/dL | ||||
Patients | 104.4 (27.1) | 104.4 (30.9) | 96.7 (23.2) | ns |
Controls | 135.3 (30.9) | 131.5 (34.8) | 135.3 (38.7) | ns |
Microalbuminuria, n (%) | ||||
Patients | 3 (6.2) | 27 (16.6) | 30 (17.3) | ns |
Controls | 2 (2.7) | 2 (2.4) | 3 (11.1) | ns |
Creatinine, µmol/L | ||||
Patients | 89.4 (12.8) | 89.6 (18.1) | 87.4 (15.8) | ns |
Controls | 73.3 (11.4) | 80.6 (14.4) | 85.9 (19.5) | I–II, I–III |
Creatinine, mg/dL | ||||
Patients | 1.01 (0.14) | 1.01 (0.20) | 0.99 (0.18) | ns |
Controls | 0.83 (0.13) | 0.91 (0.16) | 0.97 (0.22) | I–II, I–III |
GFR, mL/min/1.73 m2 | ||||
Patients | 69.9 (8.9) | 73.3 (17.1) | 72.8 (16.4) | ns |
Controls | 80.0 (13.8) | 76.9 (14.5) | 72.9 (16.3) | ns |
Systolic blood pressure, mmHg | ||||
Patients | 132 (19) | 138 (15) | 138 (17) | I–III |
Controls | 124 (18) | 129 (18) | 139 (13) | I–III |
Diastolic blood pressure, mmHg | ||||
Patients | 76 (8) | 79 (9) | 77 (8) | ns |
Controls | 71 (9) | 76 (11) | 80 (8) | I–II, I–III |
Echocardiography | ||||
LA, mm/m2 | ||||
Patients | 20.2 (2.3) | 20.5 (2.3) | 20.4 (2.3) | ns |
Controls | 20.9 (2.5) | 20.5 (4.0) | 19.6 (3.0) | ns |
LVEDV, mL/m2 | ||||
Patients | 50.2 (9.2) | 48.9 (9.4) | 46.6 (13.0) | ns |
Controls | 50.2 (9.2) | 48.9 (9.4) | 46.6 (9.9) | ns |
LV mass, g/m2 | ||||
Patients | 96.7 (20.6) | 102.0 (22.5) | 107.1 (26.4) | I–III |
Controls | 89.9 (16.9) | 100.3 (22.9) | 101.5 (32.4) | I–II |
LVEF, % | ||||
Patients | 57 (8) | 53 (8) | 49 (9) | I–II, I–III, II–III |
Controls | 58 (6) | 55 (7) | 54 (8) | I–II, I–III |
MAPSE, mm | ||||
Patients | 13 (2) | 12 (2) | 12 (2) | I–II, I–III |
Controls | 13 (2) | 12 (2) | 12 (2) | ns |
GLS, % | ||||
Patients | − 18.6 (2.3) | − 17.5 (2.3) | − 16.2 (3.0) | I–II, I–III, II–III |
Controls | − 22.3 (3.0) | − 20.8 (3.1) | − 19.6 (4.0) | I–II, I–III |
E/é | ||||
Patients | 11.9 (3.2) | 14.0 (3.8) | 14.7 (3.8) | I–II, I–III, II–III |
Controls | 10.3 (2.7) | 11.3 (3.7) | 12.5 (4.0) | I–III |