Dataset Information

Depressed systemic arterial compliance and impaired left ventricular midwall performance in aortic stenosis with concomitant type 2 diabetes: a retrospective cross-sectional study.

ABSTRACT:

Background

Degenerative aortic stenosis (AS), a disease of the elderly, frequently coexists with concomitant diseases, including type 2 diabetes (T2DM) which amplifies the cardiovascular (CV) risk. T2DM affects left ventricular (LV) structure and function via hemodynamic and metabolic factors. In concentric LV geometry, typical for AS, indices of LV midwall mechanics are better estimates of LV function than ejection fraction (EF). Effects of T2DM coexisting with AS on circumferential LV midwall systolic function and large artery properties have not been reported so far. Our aim was to compare characteristics of AS patients with and without T2DM, with a focus on LV midwall systolic function and arterial compliance.

Methods

Medical records of 130 electively hospitalized patients with moderate or severe isolated degenerative AS were retrospectively analyzed. Exclusion criteria included clinical instability, atrial fibrillation, coronary artery disease and relevant non-cardiac diseases. From in-hospital echocardiography and blood pressure, we calculated LV midwall fractional shortening (mwFS), circumferential end-systolic LV wall stress (cESS) and valvulo-arterial impedance (Zva), estimates of LV afterload, as well as systemic arterial compliance.

Results

Patients with (n?=?50) and without T2DM (n?=?80) did not differ in age, AS severity, LV mass and LV diastolic diameter. T2DM patients exhibited elevated cESS (247?±?105 vs. 209?±?84 hPa, p?=?0.025) and Zva (5.8?±?2.2 vs. 5.1?±?1.8 mmHg per mL/m², p?=?0.04), and lower stroke volume index (33?±?10 vs. 38?±?12 mL/m², p?=?0.01) and systemic arterial compliance (0.53?±?0.16 vs. 0.62?±?0.22 mL/m² per mmHg, p?=?0.01). mwFS (11.9?±?3.9 vs. 14.1?±?3.7%, p?=?0.001), but not EF (51?±?14 vs. 54?±?13%, p?=?n.s.), was reduced in T2DM. mwFS and cESS were inversely interrelated in patients both with (r?=?-?0.59, p?ConclusionsIn AS, coexistent T2DM appears associated with reduced systemic arterial compliance and LV dysfunction at the midwall level, corresponding to slightly depressed myocardial contractility.

SUBMITTER: Czestkowska E

PROVIDER: S-EPMC6636034 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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Depressed systemic arterial compliance and impaired left ventricular midwall performance in aortic stenosis with concomitant type 2 diabetes: a retrospective cross-sectional study.

Czestkowska Ewa E Rożanowska Agnieszka A Długosz Dorota D Bolt Klaudiusz K Świerszcz Jolanta J Kruszelnicka Olga O Chyrchel Bernadeta B Surdacki Andrzej A

Cardiovascular diabetology 20190717 1

<h4>Background</h4>Degenerative aortic stenosis (AS), a disease of the elderly, frequently coexists with concomitant diseases, including type 2 diabetes (T2DM) which amplifies the cardiovascular (CV) risk. T2DM affects left ventricular (LV) structure and function via hemodynamic and metabolic factors. In concentric LV geometry, typical for AS, indices of LV midwall mechanics are better estimates of LV function than ejection fraction (EF). Effects of T2DM coexisting with AS on circumferential LV ...[more]

PMID: 31315620

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Dataset Information

Depressed systemic arterial compliance and impaired left ventricular midwall performance in aortic stenosis with concomitant type 2 diabetes: a retrospective cross-sectional study.

Background

Methods

Results

Publications

Depressed systemic arterial compliance and impaired left ventricular midwall performance in aortic stenosis with concomitant type 2 diabetes: a retrospective cross-sectional study.

Similar Datasets

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