title: Insulin resistance, dietary fat intake and blood pressure predict left ventricular diastolic function 20 years later.
abstract: OBJECTIVE
  Our knowledge on the development of left ventricular diastolic dysfunction is scarce. Thus, we aimed to investigate the relationship between left ventricular diastolic function and a wide variety of cardiovascular risk factors, including dietary factors using both cross-sectional and longitudinal data with 20 years follow-up.
  
  
  RESULTS
  A population-based cohort of 505 50-year-old men was examined with determinations of blood pressure, insulin, glucose and fatty acid composition of serum cholesterol esters. A reinvestigation 20 years later also included hyperinsulinaemic euglycaemic clamp, 7-day diet record and Doppler echocardiography with determination of left ventricular diastolic function (early (E) and late (A) peak mitral velocities and left atrial diameter). Blood pressure both at age 50 and 70 was negatively correlated to the E/A ratio (r=-0.15, p<0.001 and r=-0.23, p<0.001) at age 70. Insulin resistance at age 50 and 70 were negatively correlated to the A-wave and left atrial diameter at follow-up. A fatty acid profile indicating a diet high in saturated fats at age 50 was correlated to an increased left atrial diameter 20 years later and the dietary intake of fat was negatively correlated to the E/A ratio (r=-0.09, p<0.05) at age 70. All findings were independent of myocardial infarction and cardiovascular medication.
  
  
  CONCLUSIONS
  Apart from blood pressure, insulin resistance and dietary fat intake predicted left ventricular diastolic function after 20 years. These findings suggest that both hemodynamic and metabolic factors may play a role for left ventricular diastolic function and disclose new possibilities for prevention of left ventricular diastolic dysfunction.
authors.affiliation: Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden. johan.arnlov@pubcare.uu.se
authors.forename: Johan
authors.initials: J
authors.lastname: Arnlöv
authors.forename: Lars
authors.initials: L
authors.lastname: Lind
authors.forename: Johan
authors.initials: J
authors.lastname: Sundström
authors.forename: Bertil
authors.initials: B
authors.lastname: Andrén
authors.forename: Bengt
authors.initials: B
authors.lastname: Vessby
authors.forename: Hans
authors.initials: H
authors.lastname: Lithell
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology*; D002788:Cholesterol Esters / Q000032:analysis / Q000737:chemistry; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D015930:Diet Records; D004041:Dietary Fats / Q000008:administration & dosage* / Q000378:metabolism; D004452:Echocardiography; D005227:Fatty Acids / Q000032:analysis; D005500:Follow-Up Studies; D015309:Glucose Clamp Technique; D006306:Health Surveys; D006321:Heart; D006339:Heart Rate; D006801:Humans; D007333:Insulin Resistance; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D013548:Sweden; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology* / Q000209:etiology*
chemical_list: D001786:Blood Glucose; D002788:Cholesterol Esters; D004041:Dietary Fats; D005227:Fatty Acids