Impaired glucose tolerance: A possible contributor to left ventricular hypertrophy and diastolic dysfunction

Background Approximately 40% of patients with heart failure have preserved left ventricular systolic function with latent diastolic dysfunction associated with left ventricular hypertrophy, suggesting that diastolic dysfunction participates in the pathophysiology of heart failure. However, the cause or prerequisite status of diastolic dysfunction has not been resolved. This study was designed to investigate whether impaired glucose tolerance is related to left ventricular hypertrophy and abnormal diastolic function. Methods An age/sex-matched study was performed in subjects who underwent health screening, including both a 75-g oral glucose tolerance test and Doppler echocardiography. Using the WHO criteria, the subjects were classified into the diabetic group (n = 112, 77 men/35 women, mean aged: 57.3 ± 7.6 years), the impaired glucose tolerance group (n = 226, 155 men/71 women, mean aged 56.8 ± 7.5 years), and the normal glucose tolerance group (n = 639, 438 men/201 women, mean aged 56.7 ± 7.5 years). The subjects had no symptoms or signs of chronic heart failure. Results There were no significant differences of ejection fraction, fractional shortening, and left ventricular dimensions among the three groups. However left ventricular mass was larger in the impaired glucose tolerance and the diabetic groups compared with the normal group, while the mitral E/A wave ratio was lower in the impaired glucose tolerance and the diabetic groups compared with the normal group even after adjustment for the values of blood pressure and body mass index and left ventricular mass. Conclusions These results suggest that impaired glucose tolerance is a possible contributor to left ventricular hypertrophy and diastolic dysfunction.