Independent prognostic value of left ventricular mass, diastolic function, and fasting plasma glucose

a population-based cohort stydy

Manan Pareek, Mette Lundgren Nielsen, Margrét Leósdóttir, Peter M Nilsson, Michael Hecht Olsen

Research output: Contribution to journalConference abstract in journalResearchpeer-review

Abstract

OBJECTIVE: To explore the independent prognostic value of left ventricular (LV) mass, diastolic function, and fasting plasma glucose (FPG) for the prediction of incident cardiac events in a random population sample.

DESIGN AND METHOD: 415 women and 999 men aged 56-79 years, included between 2002-2006, underwent echocardiography based on groups defined by FPG, i.e. normal (NFG): FPG ≤ 6.0 mmol/L; impaired (IFG): FPG 6.1-6.9 mmol/L; and diabetes mellitus (DM): FPG ≥ 7.0 mmol/L, self-reported DM, and/or on anti-diabetic drugs. Additive prognostic value of FPG category and echocardiography (LV mass index (LVMI), LV hypertrophy (LVH), averaged E/é, and diastolic function graded as normal, grade 1, or grade 2 + 3 diastolic dysfunction) to a prediction model with traditional cardiovascular (CV) risk factors was assessed using Cox proportional hazards regression. Cardiac events were defined as myocardial infarction, coronary revascularization, or heart failure.

RESULTS: 37 % were classified as NFG, 26 % as IFG, and 37 % as DM. Median LVMI and E/é were 86 [74-102] g/m and 8 [6-10], respectively. Over a median follow-up time of 7.8 [7.2-8.7] years, 181 events occurred. The simple prediction model included age, gender, systolic blood pressure, heart rate, previous CV disease, and use of CV medication. Addition of averaged E/é (likelihood-ratio c 11.69, p < 0.001) or LVMI (likelihood-ratio c 4.52, p = 0.03) significantly improved the model, whereas FPG category did not (likelihood-ratio c 0.48, p = 0.79). Furthermore, we detected significant interactions between both FPG category and LVH (likelihood-ratio c 9.93, p = 0.007) and FPG category and diastolic function (likelihood-ratio c 11.65, p = 0.02) for prediction of cardiac events.

CONCLUSIONS: LVMI and E/é, but not FPG category provided additional adverse prognostic value on top of traditional CV risk factors. The combination of both glucometabolic and echocardiographic abnormalities was associated with a progressively greater risk of cardiac events.

Original languageEnglish
Article numberOS 27-06
JournalJournal of Hypertension
Volume34
Issue numbere-suppl. 1
Pages (from-to)e250
Number of pages1
ISSN0263-6352
DOIs
Publication statusPublished - 2016
EventThe 26th Scientific Meeting of the International Society of Hypertension - Coex , Seoul, Korea, Republic of
Duration: 24. Sep 201629. Sep 2016

Conference

ConferenceThe 26th Scientific Meeting of the International Society of Hypertension
LocationCoex
CountryKorea, Republic of
CitySeoul
Period24/09/201629/09/2016

Fingerprint

Fasting
Population
Diabetes Mellitus
Echocardiography
Likelihood Functions
Left Ventricular Hypertrophy
Pharmaceutical Preparations

Cite this

Pareek, Manan ; Nielsen, Mette Lundgren ; Leósdóttir, Margrét ; Nilsson, Peter M ; Olsen, Michael Hecht. / Independent prognostic value of left ventricular mass, diastolic function, and fasting plasma glucose : a population-based cohort stydy. In: Journal of Hypertension. 2016 ; Vol. 34, No. e-suppl. 1. pp. e250.
@article{9f8e215675bc42a5b344827a018778f1,
title = "Independent prognostic value of left ventricular mass, diastolic function, and fasting plasma glucose: a population-based cohort stydy",
abstract = "OBJECTIVE: To explore the independent prognostic value of left ventricular (LV) mass, diastolic function, and fasting plasma glucose (FPG) for the prediction of incident cardiac events in a random population sample.DESIGN AND METHOD: 415 women and 999 men aged 56-79 years, included between 2002-2006, underwent echocardiography based on groups defined by FPG, i.e. normal (NFG): FPG ≤ 6.0 mmol/L; impaired (IFG): FPG 6.1-6.9 mmol/L; and diabetes mellitus (DM): FPG ≥ 7.0 mmol/L, self-reported DM, and/or on anti-diabetic drugs. Additive prognostic value of FPG category and echocardiography (LV mass index (LVMI), LV hypertrophy (LVH), averaged E/{\'e}, and diastolic function graded as normal, grade 1, or grade 2 + 3 diastolic dysfunction) to a prediction model with traditional cardiovascular (CV) risk factors was assessed using Cox proportional hazards regression. Cardiac events were defined as myocardial infarction, coronary revascularization, or heart failure.RESULTS: 37 {\%} were classified as NFG, 26 {\%} as IFG, and 37 {\%} as DM. Median LVMI and E/{\'e} were 86 [74-102] g/m and 8 [6-10], respectively. Over a median follow-up time of 7.8 [7.2-8.7] years, 181 events occurred. The simple prediction model included age, gender, systolic blood pressure, heart rate, previous CV disease, and use of CV medication. Addition of averaged E/{\'e} (likelihood-ratio c 11.69, p < 0.001) or LVMI (likelihood-ratio c 4.52, p = 0.03) significantly improved the model, whereas FPG category did not (likelihood-ratio c 0.48, p = 0.79). Furthermore, we detected significant interactions between both FPG category and LVH (likelihood-ratio c 9.93, p = 0.007) and FPG category and diastolic function (likelihood-ratio c 11.65, p = 0.02) for prediction of cardiac events.CONCLUSIONS: LVMI and E/{\'e}, but not FPG category provided additional adverse prognostic value on top of traditional CV risk factors. The combination of both glucometabolic and echocardiographic abnormalities was associated with a progressively greater risk of cardiac events.",
author = "Manan Pareek and Nielsen, {Mette Lundgren} and Margr{\'e}t Le{\'o}sd{\'o}ttir and Nilsson, {Peter M} and Olsen, {Michael Hecht}",
year = "2016",
doi = "10.1097/01.hjh.0000500566.79672.d9",
language = "English",
volume = "34",
pages = "e250",
journal = "Journal of Hypertension",
issn = "0263-6352",
publisher = "Lippincott Williams & Wilkins, Ltd.",
number = "e-suppl. 1",

}

Independent prognostic value of left ventricular mass, diastolic function, and fasting plasma glucose : a population-based cohort stydy. / Pareek, Manan; Nielsen, Mette Lundgren; Leósdóttir, Margrét; Nilsson, Peter M; Olsen, Michael Hecht.

In: Journal of Hypertension, Vol. 34, No. e-suppl. 1, OS 27-06, 2016, p. e250.

Research output: Contribution to journalConference abstract in journalResearchpeer-review

TY - ABST

T1 - Independent prognostic value of left ventricular mass, diastolic function, and fasting plasma glucose

T2 - a population-based cohort stydy

AU - Pareek, Manan

AU - Nielsen, Mette Lundgren

AU - Leósdóttir, Margrét

AU - Nilsson, Peter M

AU - Olsen, Michael Hecht

PY - 2016

Y1 - 2016

N2 - OBJECTIVE: To explore the independent prognostic value of left ventricular (LV) mass, diastolic function, and fasting plasma glucose (FPG) for the prediction of incident cardiac events in a random population sample.DESIGN AND METHOD: 415 women and 999 men aged 56-79 years, included between 2002-2006, underwent echocardiography based on groups defined by FPG, i.e. normal (NFG): FPG ≤ 6.0 mmol/L; impaired (IFG): FPG 6.1-6.9 mmol/L; and diabetes mellitus (DM): FPG ≥ 7.0 mmol/L, self-reported DM, and/or on anti-diabetic drugs. Additive prognostic value of FPG category and echocardiography (LV mass index (LVMI), LV hypertrophy (LVH), averaged E/é, and diastolic function graded as normal, grade 1, or grade 2 + 3 diastolic dysfunction) to a prediction model with traditional cardiovascular (CV) risk factors was assessed using Cox proportional hazards regression. Cardiac events were defined as myocardial infarction, coronary revascularization, or heart failure.RESULTS: 37 % were classified as NFG, 26 % as IFG, and 37 % as DM. Median LVMI and E/é were 86 [74-102] g/m and 8 [6-10], respectively. Over a median follow-up time of 7.8 [7.2-8.7] years, 181 events occurred. The simple prediction model included age, gender, systolic blood pressure, heart rate, previous CV disease, and use of CV medication. Addition of averaged E/é (likelihood-ratio c 11.69, p < 0.001) or LVMI (likelihood-ratio c 4.52, p = 0.03) significantly improved the model, whereas FPG category did not (likelihood-ratio c 0.48, p = 0.79). Furthermore, we detected significant interactions between both FPG category and LVH (likelihood-ratio c 9.93, p = 0.007) and FPG category and diastolic function (likelihood-ratio c 11.65, p = 0.02) for prediction of cardiac events.CONCLUSIONS: LVMI and E/é, but not FPG category provided additional adverse prognostic value on top of traditional CV risk factors. The combination of both glucometabolic and echocardiographic abnormalities was associated with a progressively greater risk of cardiac events.

AB - OBJECTIVE: To explore the independent prognostic value of left ventricular (LV) mass, diastolic function, and fasting plasma glucose (FPG) for the prediction of incident cardiac events in a random population sample.DESIGN AND METHOD: 415 women and 999 men aged 56-79 years, included between 2002-2006, underwent echocardiography based on groups defined by FPG, i.e. normal (NFG): FPG ≤ 6.0 mmol/L; impaired (IFG): FPG 6.1-6.9 mmol/L; and diabetes mellitus (DM): FPG ≥ 7.0 mmol/L, self-reported DM, and/or on anti-diabetic drugs. Additive prognostic value of FPG category and echocardiography (LV mass index (LVMI), LV hypertrophy (LVH), averaged E/é, and diastolic function graded as normal, grade 1, or grade 2 + 3 diastolic dysfunction) to a prediction model with traditional cardiovascular (CV) risk factors was assessed using Cox proportional hazards regression. Cardiac events were defined as myocardial infarction, coronary revascularization, or heart failure.RESULTS: 37 % were classified as NFG, 26 % as IFG, and 37 % as DM. Median LVMI and E/é were 86 [74-102] g/m and 8 [6-10], respectively. Over a median follow-up time of 7.8 [7.2-8.7] years, 181 events occurred. The simple prediction model included age, gender, systolic blood pressure, heart rate, previous CV disease, and use of CV medication. Addition of averaged E/é (likelihood-ratio c 11.69, p < 0.001) or LVMI (likelihood-ratio c 4.52, p = 0.03) significantly improved the model, whereas FPG category did not (likelihood-ratio c 0.48, p = 0.79). Furthermore, we detected significant interactions between both FPG category and LVH (likelihood-ratio c 9.93, p = 0.007) and FPG category and diastolic function (likelihood-ratio c 11.65, p = 0.02) for prediction of cardiac events.CONCLUSIONS: LVMI and E/é, but not FPG category provided additional adverse prognostic value on top of traditional CV risk factors. The combination of both glucometabolic and echocardiographic abnormalities was associated with a progressively greater risk of cardiac events.

U2 - 10.1097/01.hjh.0000500566.79672.d9

DO - 10.1097/01.hjh.0000500566.79672.d9

M3 - Conference abstract in journal

VL - 34

SP - e250

JO - Journal of Hypertension

JF - Journal of Hypertension

SN - 0263-6352

IS - e-suppl. 1

M1 - OS 27-06

ER -