Author + information
- Rupan Bose,
- Millie Arora,
- Fahim Abbasi,
- Esha Roy,
- Shriram Nallamshetty,
- Abha Khandelwal,
- Prajakta Ranade and
- Rajesh Dash
Background: Left Ventricular Hypertrophy (LVH) is associated with increased Cardiovascular (CV) mortality. South Asians exhibit the highest rates of CV mortality, with first events occurring 11 years earlier than other ethnicities. It is unknown whether LVH, a marker of adverse cardiac remodeling, also manifests at earlier ages in South Asians, and whether this LVH is driven by the traditional risk factor hypertension (HTN). As metabolic disorders like Insulin Resistance (IR) may play a role in LVH, we studied whether IR may correlate with LVH remodeling independent of HTN in South Asians.
Methods: 55 patients (mean age = 44 ± 13 yrs) were recruited from Stanford's South Asian Translational Heart Initiative, which is dedicated to treating CV disease in young South Asians. Risk factors, including blood pressure (BP) and interventricular septal wall thickness (IVSd, by echocardiography) were measured. Oral glucose tolerance tests were used to determine insulin resistance and quantified by the Matsuda Index (MI). Associations between BP, MI, and IVSd were analyzed.
Results: The mean age of patients with IR (MI < 3.8) was 46 ± 13 years, and the mean age of patients with HTN (systolic BP > 140) was 47 ± 17 years. Linear regression between MI and IVSd found a trend toward a significant inverse relationship (p = 0.076), whereas a significant positive relationship between systolic BP and IVSd was found (p = 0.0029). When analyzing patients without HTN (systolic BP < 140, n = 38), a significant inverse relationship between MI and IVSd was evident (p = 0.029). Of the patients with LVH (IVSd ≥ 1.1cm, n = 13), 77% had IR, 46% had HTN, 46% had IR without HTN, and 15% had HTN without IR.
Conclusions: Our results show that while both IR and HTN are associated with LVH in South Asians, there was a significant association between IR and LVH in the absence of HTN. Also, the mean age of patients with IR was younger than those with HTN. Therefore, South Asians may exhibit an unique disease pattern where IR plays a larger role in cardiac end-organ damage than HTN, prompting special attention to metabolic disorders when treating cardiovascular risk in South Asian patients.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Diabetes and Other Issues in Cardiovascular Prevention
Abstract Category: 32. Prevention: Clinical
Presentation Number: 1277-067
- 2017 American College of Cardiology Foundation