Asymmetric septal hypertrophy and diabetes mellitus in patients with coronary artery disease

Abstract

Background: There is evidence to indicate that asymmetric septal hypertrophy (ASH) in patients with coronary artery disease (CAD) is related to the left ventricular remodeling after myocardial infarction and systemic hypertension. We evaluated whether diabetes mellitus is associated with ASH in CAD patients. Methods: We recruited 2553 consecutive patients (age 51.4±7.6 years) with angiographic CAD (>50% stenosis). Echocardiography revealed ASH (interventricular septum to LV free wall thickness ratio >1.3) in 266 patients (10.4%) (Group 1). Group 2 consisted of 2287 patients without ASH. Patients with acute myocardial infarction were excluded. Results: The groups were matched for age and sex. The prevalence of diabetes mellitus in Group 1 was higher (9.8% vs. 5.5%, p=0.005) as well as the incidence of prior myocardial infarction (88.7 vs. 67.9%, p<0.001), systemic hypertension (65.4 vs. 58.5%, p=0.034) and obesity (40.5 vs. 33.1%, p=0.017). There were no significant differences in other traditional risk factors for CAD. Multivariate analyses identified diabetes mellitus (p=0.025), prior myocardial infarction (p<0.001), systemic hypertension (p=0.008) to be independently associated with ASH. Conclusion: ASH is common in patients with CAD and independently associated with diabetes mellitus as well as prior myocardial infarction and systemic hypertension.