title: Impact of diabetes on cardiac structure and function: the strong heart study.
abstract: BACKGROUND
  Whether diabetes mellitus (DM) adversely affects left ventricular (LV) structure and function independently of increases in body mass index (BMI) and blood pressure is controversial.
  
  
  RESULTS
  Echocardiography was used in the Strong Heart Study, a study of cardiovascular disease in American Indians, to compare LV measurements between 1810 participants with DM and 944 with normal glucose tolerance. Participants with DM were older (mean age, 60 versus 59 years), had higher BMI (32.4 versus 28.9 kg/m(2)) and systolic blood pressure (133 versus 124 mm Hg), and were more likely to be female, to be on antihypertensive treatment, and to live in Arizona (all P<0.001). In analyses adjusted for covariates, women and men with DM had higher LV mass and wall thicknesses and lower LV fractional shortening, midwall shortening, and stress-corrected midwall shortening (all P<0.002). Pulse pressure/stroke volume, a measure of arterial stiffness, was higher in participants with DM (P<0.001 independent of confounders).
  
  
  CONCLUSIONS
  Non-insulin-dependent DM has independent adverse cardiac effects, including increased LV mass and wall thicknesses, reduced LV systolic chamber and myocardial function, and increased arterial stiffness. These findings identify adverse cardiovascular effects of DM, independent of associated increases in BMI and arterial pressure, that may contribute to cardiovascular events in diabetic individuals.
authors.affiliation: New York Hospital-Cornell Medical Center, New York, USA. rbdevere@mail.med.cornell.edu
authors.forename: R B
authors.initials: RB
authors.lastname: Devereux
authors.forename: M J
authors.initials: MJ
authors.lastname: Roman
authors.forename: M
authors.initials: M
authors.lastname: Paranicas
authors.forename: M J
authors.initials: MJ
authors.lastname: O'Grady
authors.forename: E T
authors.initials: ET
authors.lastname: Lee
authors.forename: T K
authors.initials: TK
authors.lastname: Welty
authors.forename: R R
authors.initials: RR
authors.lastname: Fabsitz
authors.forename: D
authors.initials: D
authors.lastname: Robbins
authors.forename: E R
authors.initials: ER
authors.lastname: Rhoades
authors.forename: B V
authors.initials: BV
authors.lastname: Howard
mesh_terms: D000368:Aged; D003920:Diabetes Mellitus / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D004452:Echocardiography; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007198:Indians, North American; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012016:Reference Values; D012727:Sex Characteristics; D016277:Ventricular Function, Left