Abstract
Abstract Funding Acknowledgements Type of funding sources: None. Background Suboptimal glycemic control characterized by high glucose variability pose inherent risks for the development of diabetic cardiomyopathy. The tangible association between type 2 diabetes mellitus (T2DM) and Heart Failure with Preserved Ejection Fraction (HFpEF) also has been widely studied. However, whether glycemic variability (GV) may independently associated with left ventricular (LV) diastolic dysfunction in T2DM patients with HFpEF remained elusive. Purpose To investigate association between GV and diastolic dysfunction in T2DM patients with HFpEF. Methods A cross-sectional study utilizing electronic medical record database from 2018 to 2021. Total of 66 patients with T2DM and HFpEF without coronary artery disease were enrolled. Baseline characteristics, clinical and laboratory variables, medication and echocardiography data were obtained. GV were calculated from standard deviation of multiple blood glucose measurement prior to echocardiography. Subjects were divided into two groups according to mean GV; high and low GV respectively. Diastolic function was analyzed applying echocardiographic parameters. Results LV Ejection Fraction (LVEF) was significantly lower in high GV (≥ 49.45 mg/dL) as compared to patients with low GV (65.48±9.47 vs 68.20±8.12, p=0.0408) despite similar baseline characteristics. Furthermore, high GV displayed a significant positive correlation with E/e’ (Pearson’s correlation r = 0.441; p=0.044). More importantly, univariate analysis using Fisher’s exact test revealed that High GV significantly associated with diastolic dysfunction (odds ratio: 8.16; 95% confidence interval = 1.143–95.97; p=0.0451). Conclusion High GV was significantly associated with lower LVEF and diastolic dysfunction. Optimal glycemic control represented by low GV may become an appealing approach to prevent HFpEF progression in T2DM patients.
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