Abstract 16295: Glucose Homeostasis and Frequency of Pre-Heart Failure in Hispanics/Latinos: Insights From the Echocardiographic Study of Latinos (ECHO SOL)

Abstract

BACKGROUND: Diabetes Mellitus (DM) is an independent risk factor for heart failure (HF), yet research on the association of glucose homeostasis with pre-HF is limited. We assessed glucose homeostasis longitudinally in relation to prevalent and incident pre-HF in the Echocardiographic Study of Latinos, Echo-SOL. Methods: Serial echocardiograms from 1595 adults (mean age 56.4 years), 61% female, from Echo SOL were analyzed on average 4.3 years apart. Prevalent pre-HF was defined as the presence of one of the following parameters: LVEF <50%, global longitudinal strain > -15%, diastolic dysfunction ≥ grade 1, left ventricular mass index >115 in men/>95 in women, relative wall thickness >0.42. Glucose homeostasis was assessed at baseline (2008-2011) by fasting plasma glucose (FGP), oral glucose tolerance test (OGTT), and hemoglobin A1C (A1C) and categorized as normal glucose tolerance [NGT]: FPG<100 mg/dL, OGTT <140 mg/dL, and A1C <5.7%; prediabetes [PDM]: FPG 100-125 mg/dL, OGTT 140-199 mg/dL, or A1C 5.7-6.4%. Among those with prevalent DM, controlled DM [CDM] was defined as A1C <7%, and uncontrolled DM [UDM] as A1C >7%. Incident pre-HF was assessed at visit 2 (2014-2017) among those free of pre-HF at visit 1. Complex survey design is accounted for in all analyses. Results: Over time there was increased frequency of UDM with decreased frequency of NGT (Figure) . Prevalent pre-HF (72.5% overall) gradually increased as glucose homeostasis worsened: 50.5% NGT, 69.2% PDM, 78.3% CDM, 86% UDM, p value <0.05. Incident pre-HF (56.2% overall) occurred more frequently among baseline dysregulated glucose categories: 65.5% PDM, 71.3% UDM, p value <0.05. CONCLUSION: Pre-HF rates, in both the non-DM and DM groups, increase with worsening and uncontrolled glucose homeostasis. Early detection of antecedent PDM stages and uncontrolled diabetes may offer opportunities to prevent clinical HF.