title: Plasma glucose levels and left ventricular diastolic function in nondiabetic hypertensive patients.
abstract: BACKGROUND
  Changes in left ventricular (LV) diastolic filling anticipate diastolic heart failure and are frequently detected in patients with hypertension or diabetes. We tested the hypothesis that increased fasting and postload glucose levels are associated with diastolic dysfunction as assessed by tissue Doppler imaging (TDI) in hypertensive patients.
  
  
  METHODS
  In 104 untreated, nondiabetic, hypertensive patients free of cardiovascular complications, we measured glucose and insulin at fast and after an oral glucose load, calculated the Homeostatic Model Assessment (HOMA) index, and performed electrocardiogram (ECG), conventional echocardiography, and TDI.
  
  
  RESULTS
  Thirty-one patients who had impaired fasting glucose/impaired glucose tolerance had more frequent LV strain at ECG and worse TDI markers of diastolic function than patients with normal plasma glucose but no differences in variables LV mass, LV geometry, systolic function, and early-/late-wave transmitral diastolic velocity. TDI detected diastolic dysfunction in 46 patients who were older and had greater body mass index, blood pressure, fasting and postload glucose, insulin, HOMA index, LV mass, and left atrial diameter than patients with preserved diastolic function. Variables of diastolic function measured at TDI were significantly related with age, body mass index, LV mass, and fasting and postload plasma glucose. Stepwise regression analysis showed that the relationship of markers of diastolic dysfunction with both fasting and postload glucose levels was independent of possible confounders.
  
  
  CONCLUSIONS
  Initially abnormal fasting and postload glucose levels are associated with more prominent diastolic impairment in uncomplicated hypertensive patients, suggesting that hyperglycemia might increase the risk of diastolic heart failure even in the absence of diabetes.
authors.affiliation: Hypertension Unit, Division of Internal Medicine, Department of Experimental and Clinical Medical Science, University of Udine, Udine, Italy. cristiana.catena@uniud.it.
authors.forename: Cristiana
authors.initials: C
authors.lastname: Catena
authors.affiliation: Hypertension Unit, Division of Internal Medicine, Department of Experimental and Clinical Medical Science, University of Udine, Udine, Italy.
authors.forename: GianLuca
authors.initials: G
authors.lastname: Colussi
authors.affiliation: Hypertension Unit, Division of Internal Medicine, Department of Experimental and Clinical Medical Science, University of Udine, Udine, Italy.
authors.forename: Flavia
authors.initials: F
authors.lastname: Martinis
authors.affiliation: Hypertension Unit, Division of Internal Medicine, Department of Experimental and Clinical Medical Science, University of Udine, Udine, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Pezzutto
authors.affiliation: Hypertension Unit, Division of Internal Medicine, Department of Experimental and Clinical Medical Science, University of Udine, Udine, Italy.
authors.forename: Leonardo A
authors.initials: LA
authors.lastname: Sechi
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000502:physiology*; D003430:Cross-Sectional Studies; D003971:Diastole; D015150:Echocardiography, Doppler; D005215:Fasting / Q000097:blood; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D018487:Ventricular Dysfunction, Left / Q000097:blood*; D016277:Ventricular Function, Left
chemical_list: D001786:Blood Glucose
keywords: blood pressure; echocardiography; hypertension; impaired fasting glucose; impaired glucose tolerance; insulin; left ventricular strain; oral glucose tolerance test; tissue Doppler imaging.