title: Abnormal glucose and lipid control in non-ischemic left ventricular dysfunction.
abstract: BACKGROUND
  Cardiovascular risk factors are classically associated with coronary atherosclerosis. We sought to investigate whether risk factors are also associated with left ventricular (LV) dilatation, contractile impairment and reduced myocardial blood flow (MBF) in patients with non-ischemic LV dysfunction.
  
  
  METHODS
  We studied 81 patients (59 males, age 60 ± 9 years) with mild-to-severe LV dysfunction (mean ejection fraction 37%, range 19%-50%), no history of diabetes and normal coronary arteries. Absolute MBF was measured by positron emission tomography and (13)N-ammonia at rest and after dipyridamole (0.56 mg/kg I.V. over 4 min).
  
  
  RESULTS
  Overt LV dysfunction (LV end-diastolic diameter >60 mm associated with LV ejection fraction <45%) was present in 42 patients (52%); severely depressed hyperemic MBF (<1.09 mL · min(-1) · g(-1)) was present in 41 patients (51%). Using multivariate logistic regression analysis, low high-density lipoprotein cholesterol (HDL-C, P < .036), newly diagnosed non-insulin-dependent diabetes or insulin-resistance (NIDD/IR, P < .019) and the use of diuretics (P = .001) were independently associated with overt LV dysfunction. Low HDL-C (P = .015) and NIDD/IR (P = .048) were also independently associated with severely depressed hyperemic MBF.
  
  
  CONCLUSIONS
  Low HDL-C and NIDD/IR are associated with more severe LV impairment and reduced hyperemic MBF in non-ischemic LV dysfunction.
authors.affiliation: CNR Institute of Clinical Physiology, Pisa, Italy.
authors.forename: Danilo
authors.initials: D
authors.lastname: Neglia
authors.forename: Tiziana
authors.initials: T
authors.lastname: Sampietro
authors.forename: Cecilia
authors.initials: C
authors.lastname: Vecoli
authors.forename: Riccardo
authors.initials: R
authors.lastname: Liga
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Rossi
authors.forename: Elena
authors.initials: E
authors.lastname: Filidei
authors.forename: Federico
authors.initials: F
authors.lastname: Bigazzi
authors.forename: Patricia
authors.initials: P
authors.lastname: Iozzo
authors.forename: Daniela
authors.initials: D
authors.lastname: Giannessi
authors.forename: Antonio
authors.initials: A
authors.lastname: L'Abbate
authors.forename: Daniele
authors.initials: D
authors.lastname: Rovai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000641:Ammonia; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D008076:Cholesterol, HDL / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging*; D003326:Coronary Circulation; D004176:Dipyridamole; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009590:Nitrogen Radioisotopes; D049268:Positron-Emission Tomography / Q000379:methods; D011237:Predictive Value of Tests; D012146:Rest; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014665:Vasodilator Agents; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000000981:diagnostic imaging* / Q000209:etiology
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D008076:Cholesterol, HDL; D009590:Nitrogen Radioisotopes; D014665:Vasodilator Agents; D004176:Dipyridamole; D000641:Ammonia