Abstract 14490: Relationship Between Right Heart Catheterization Hemodynamics and Glycosylated Hemoglobin Levels in Adults With Heart Failure With Reduced Ejection Fraction

Abstract

Introduction: Elevated glycosylated hemoglobin (HbA1c) levels have been associated with adverse outcomes in heart failure (HF). However, the relationship between hemodynamics and glycemia has not been established. Hypothesis: Elevated HbA1c levels are associated with abnormal right heart catheterization (RHC) hemodynamic parameters in patients with HF with reduced ejection fraction and no prior diagnosis of diabetes mellitus (DM). Methods: We performed a retrospective study of adults patients (>21 years) with a left ventricular ejection fraction <40% who underwent a RHC between June 1, 2015 and June 1, 2021 and had HbA1c levels measured 30 days before or after the RHC. We excluded patients who had received blood transfusions within 90 days prior to HbA1c measurement and patients with known DM. We conducted univariate and multivariate regression analysis adjusted for age, gender, and body mass index (BMI) to test for an association between RHC hemodynamic parameters and HbA1c. Results: A total of 136 patients were included with a mean age of 55 ± 15 years; 75% were males. The mean BMI was 29.88 ± 8.08 kg/m2, and meanHbA1c was 5.99 ± 0.64%. Unadjusted univariate models showed that HbA1c is significantly associated with cardiac index (CI) by Fick and thermodilution, right atrial pressure (RAP), and mean pulmonary arterial pressure (mPAP). After multivariateanalysis, for every one unit increase in HbA1c, there was a 0.19 and 0.26 L/min/m2decrease in expected CI by thermodilution and by Fick, respectively ( P = 0.03 and P <0.01). For every one unit increase in HbA1c, there was a 2.39 mmHg increase in expected RAP ( P = 0.01). There was no association between MPAP and HbA1c after adjustment (Table 1). Conclusions: Changes in HbA1c levels measured within 30 days before or after the index RHC in patients with a left ventricular ejection fraction <40% were associated withchanges in hemodynamic parameters that correlate with congestive hemodynamics(reduced CI and elevated RAP).