Hemodynamic and metabolic factors in the prediction of diastolic dysfunction

M. Nielsen, M. Pareek, T. B. Olesen, M. Leosdottir, P. M. Nilsson, M. H. Olsen

Publikation: Bidrag til tidsskriftKonferenceabstrakt i tidsskriftForskningpeer review


Objective: To explore possible hemodynamic and metabolic determinants of diastolic dysfunction in a random population sample. Design and method: We examined associations between hemodynamic factors (systolic blood pressure (SBP), heart rate (HR)), metabolic factors (fasting insulin, fasting plasma glucose, 2-hour glucose during oral glucose tolerance test (OGTT), oral disposition index (DIo), and Homeostatic Model Assessment (HOMA) derived indices of beta-cell function (HOMA-2B), insulin sensitivity (HOMA-2S), and insulin resistance (HOMA-2IR)), other traditional cardiovascular risk factors, and later detection of grade 2 or 3 diastolic dysfunction (DD) in 243 men and 22 women aged 28 to 57 years at the time of inclusion, using binary logistic regression analysis. Study subjects came from a random population based sample and were included 1974-1992, whilst the echocardiography was performed 2002-2006. Results: After a mean follow-up time of 27 years, grade 2 or 3 diastolic dysfunction was detected in 34% (n = 89) of subjects. In univariate analyses (significance level 0.05), diastolic dysfunction was associated with age, sex, heart rate, systolic blood pressure, fasting insulin levels, 2-hour glucose levels, HOMA-2B, HOMA- 2S, HOMA-2IR, and the time elapsed between inclusion and echocardiography. In multivariable analysis (significance level 0.20), sex (odds ratio (OR) = 6.08 (95% confidence interval (CI), 1.26-29.25); p = 0.02), heart rate (OR = 1.02 (95% CI, 0.996-1.05); p = 0.1), HOMA-2B (OR = 1.01 (95% CI, 1.00-1.01); p = 0.051), and time span (OR = 1.84 (95% CI, 1.73-1.96); p = 0.01), remained significantly associated with diastolic dysfunction, whereas age was forced into the model (OR = 1.03 (95% CI, 0.96-1.11); p = 0.41). We did not detect any significant interactions between HOMA-2B and other variables in the prediction of diastolic dysfunction. Conclusions: In a binary logistic regression model adjusted for age, sex, and time, HOMA-2B was significantly associated with the development of grade 2 or 3 diastolic dysfunction. It is suggested that subjects with increased HOMA-2B values may be at greater cardiovascular risk.
TidsskriftJournal of Hypertension
Udgave nummere-Supplement 1
Sider (fra-til)e202
Antal sider1
StatusUdgivet - 2015
Begivenhed25th European Meeting on Hypertension and Cardiovascular Protection - Milano, Italien
Varighed: 12. jun. 201515. jun. 2015


Konference25th European Meeting on Hypertension and Cardiovascular Protection


  • *diastolic dysfunction *European *hypertension *protection *prediction diet restriction heart rate model echocardiography oral glucose tolerance test logistic regression analysis human systolic blood pressure population cardiovascular risk insulin resistance insulin sensitivity confidence interval risk univariate analysis follow up cell function female male glucose blood level insulin glucose