Higher hemoglobin A1c levels are associated with impaired left ventricular diastolic function and higher incidence of adverse cardiac events in ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2016-09-26

AUTHORS

Yuki Ikeda, Takayuki Inomata, Teppei Fujita, Yuichiro Iida, Toyoji Kaida, Takeru Nabeta, Shunsuke Ishii, Emi Maekawa, Tomoyoshi Yanagisawa, Tomohiro Mizutani, Takashi Naruke, Toshimi Koitabashi, Ichiro Takeuchi, Junya Ako

ABSTRACT

We aimed to elucidate the relationship between glycated hemoglobin (HbA1c), cardiac systolic/diastolic function, and heart failure (HF) prognosis during guideline-directed medical therapy in patients with nonischemic dilated cardiomyopathy (NIDCM). We evaluated 283 hospitalized NIDCM patients, who were grouped according to baseline (BL) and 1-year (1Y) levels of HbA1c (<6.0, 6.0–6.9, and ≥7.0 %). The primary endpoint was defined as either readmission for HF worsening or cardiac death. Approximately half of the patients had BL- or 1Y-HbA1c ≥6.0 % (31 % at BL, 34 % at 1Y had 6.0–6.9 %; 12 % at BL, 12 % at 1Y had ≥7.0 %). The absolute value of left ventricular ejection fraction (LVEF) and its improvement during 1 year showed no significant difference among the 1Y-HbA1c groups (p = 0.273), whereas a lower absolute value and a more significant reduction in the early diastolic velocity of the mitral annulus (Ea) were seen in the group with 1Y-HbA1c ≥7.0 % (both p < 0.001). In multiple regression analysis, higher 1Y-plasma B-type natriuretic peptide and lower 1Y-Ea were independently associated with higher 1Y-HbA1c (both adjusted p < 0.05). The cumulative incidence of the primary endpoint was highest in the group with 1Y-HbA1c ≥7.0 % (log-rank p = 0.001). Multivariate analysis demonstrated that higher 1Y-HbA1c was independently associated with a higher incidence of the primary endpoint (adjusted p = 0.005). In conclusion, hyperglycemia during clinical follow-up is a risk factor for progression of concomitant LV abnormal relaxation, leading to poor HF prognosis in patients with NIDCM. More... »

PAGES

446-457

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00380-016-0895-x

DOI

http://dx.doi.org/10.1007/s00380-016-0895-x

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1015743007

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/27672077


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30 schema:description We aimed to elucidate the relationship between glycated hemoglobin (HbA1c), cardiac systolic/diastolic function, and heart failure (HF) prognosis during guideline-directed medical therapy in patients with nonischemic dilated cardiomyopathy (NIDCM). We evaluated 283 hospitalized NIDCM patients, who were grouped according to baseline (BL) and 1-year (1Y) levels of HbA1c (<6.0, 6.0–6.9, and ≥7.0 %). The primary endpoint was defined as either readmission for HF worsening or cardiac death. Approximately half of the patients had BL- or 1Y-HbA1c ≥6.0 % (31 % at BL, 34 % at 1Y had 6.0–6.9 %; 12 % at BL, 12 % at 1Y had ≥7.0 %). The absolute value of left ventricular ejection fraction (LVEF) and its improvement during 1 year showed no significant difference among the 1Y-HbA1c groups (p = 0.273), whereas a lower absolute value and a more significant reduction in the early diastolic velocity of the mitral annulus (Ea) were seen in the group with 1Y-HbA1c ≥7.0 % (both p < 0.001). In multiple regression analysis, higher 1Y-plasma B-type natriuretic peptide and lower 1Y-Ea were independently associated with higher 1Y-HbA1c (both adjusted p < 0.05). The cumulative incidence of the primary endpoint was highest in the group with 1Y-HbA1c ≥7.0 % (log-rank p = 0.001). Multivariate analysis demonstrated that higher 1Y-HbA1c was independently associated with a higher incidence of the primary endpoint (adjusted p = 0.005). In conclusion, hyperglycemia during clinical follow-up is a risk factor for progression of concomitant LV abnormal relaxation, leading to poor HF prognosis in patients with NIDCM.
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37 B-type natriuretic peptide
38 HF prognosis
39 HF worsening
40 NIDCM
41 NIDCM patients
42 abnormal relaxation
43 absolute value
44 adverse cardiac events
45 analysis
46 annulus
47 baseline
48 cardiac death
49 cardiac events
50 cardiac systolic/diastolic function
51 cardiomyopathy
52 conclusion
53 cumulative incidence
54 death
55 diastolic function
56 diastolic velocity
57 differences
58 early diastolic velocity
59 ejection fraction
60 endpoint
61 events
62 factors
63 failure prognosis
64 fraction
65 function
66 glycated hemoglobin
67 group
68 guideline-directed medical therapy
69 half
70 heart failure prognosis
71 hemoglobin
72 hemoglobin A1c levels
73 high incidence
74 higher hemoglobin A1c levels
75 hyperglycemia
76 improvement
77 incidence
78 levels
79 lower absolute values
80 medical therapy
81 mitral annulus
82 multiple regression analysis
83 multivariate analysis
84 natriuretic peptide
85 patients
86 peptides
87 primary endpoint
88 prognosis
89 progression
90 readmission
91 reduction
92 regression analysis
93 relationship
94 relaxation
95 risk factors
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105 years
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