Left ventricular hypertrophy and its relation with inflammation in type 2 diabetic patients
Ergita Nelaj, Margarita Gjata, Edite Sadiku, Ledio Collaku & Mihal Tase
Introduction: The association between diabetes and adverse cardiovascular outcome may be partially explained by the strong independent association of type 2 diabetes with cardiovascular target organ damage, such as left ventricular hypertrophy (LVH), a well-known predictor of cardiovascular events independent of coronary artery disease. The aim of the present study is to evaluate the relation of LVH to fibrinogen and C-reactive protein (CRP) as markers of inflammation and susceptibility to atherothrombosis.
Methods and subjects: We selected 50 adults with type 2 diabetes. 32 were women and 18 were men, mean age 45±14. Hypertension was defined by systolic blood pressure (sBP) 140 mmHg and/or diastolic blood pressure (dBP) 90 mmHg. Diabetes was defined by fasting plasma glucose levels 126 mg/dl or by specific treatment. BMI was calculated by the standard formula.
Echocardiography methods: The prevalence of left ventricular abnormalities has been determined by bidimensional echocardiography. The left ventricular mass index (LVMI) has been evaluated according to the method of Devereux and Reichek.
Participants laboratory data were examined in the morning after an overnight fast 12 h. The levels of CRP and fibrinogen have been measured.
Results: From 50 participants, 22 (44%) presented LVH, which was associated with higher BMI and CRP, fibrinogen levels, left ventricular hypertrophy, markers of inflammation. We found relationships between fibrinogen and concentric LVH (P<0.001) and also between CRP with concentric hypertrophy (P<0.005).
Conclusions: Twenty-two patients presented concentric LVH, 10 patients eccentric LVH, and 18 patients normal LV mass. Concentric LVH was associated with elevated markers of systemic inflammation and susceptibility to atherothrombosis (CRP and fibrinogen levels) independently of clinically overt cardiovascular disease and traditional cardiovascular risk factors. No correlation was found between CRP and fibrinogen and eccentric LVH.