Impact of Diabetes and Increasing Body Mass Index Category on Left Ventricular Systolic and Diastolic Function.
BACKGROUND
Diabetes and obesity are both worldwide growing epidemics, and both are independently associated with increased risk for heart failure and death. The aim of this study was to examine the additive detrimental effect of both diabetes and increasing body mass index (BMI) category on left ventricular (LV) myocardial systolic and diastolic function.


METHODS
The present retrospective multicenter study included 653 patients (337 with type 2 diabetes and 316 without diabetes) of increasing BMI category. All patients had normal LV ejection fractions. LV myocardial systolic (peak systolic global longitudinal strain and peak systolic global longitudinal strain rate) and diastolic (average mitral annular e' velocity and early diastolic global longitudinal strain rate) function was quantified using echocardiography.


RESULTS
Increasing BMI category was associated with progressively more impaired LV myocardial function in patients with diabetes (P < .001). Patients with diabetes had significantly more impaired LV myocardial function for all BMI categories compared with those without diabetes (P < .001). On multivariate analysis, both diabetes and obesity were independently associated with an additive detrimental effect on LV myocardial systolic and diastolic function. However, obesity was associated with greater LV myocardial dysfunction than diabetes.


CONCLUSION
Both diabetes and increasing BMI category had an additive detrimental effect on LV myocardial systolic and diastolic function. Furthermore, increasing BMI category was associated with greater LV myocardial dysfunction than diabetes. As they frequently coexist together, future studies on patients with diabetes should also focus on obesity.
['Ng|Arnold C T|ACT|', 'Prevedello|Francesca|F|', 'Dolci|Giulia|G|', 'Roos|Cornelis J|CJ|', 'Djaberi|Roxana|R|', 'Bertini|Matteo|M|', 'Ewe|See Hooi|SH|', 'Allman|Christine|C|', 'Leung|Dominic Y|DY|', 'Marsan|Nina Ajmone|NA|', 'Delgado|Victoria|V|', 'Bax|Jeroen J|JJ|']
D015992:Body Mass Index D003924:Diabetes Mellitus, Type 2 D003971:Diastole D004452:Echocardiography D006801:Humans D008875:Middle Aged D012189:Retrospective Studies D013599:Systole D018487:Ventricular Dysfunction, Left
Obesity Cardiomyopathy Diabetes mellitus Ventricles