LEFT VENTRICULAR GEOMETRIC PATTERNS AND TRIGLYCERIDE–GLUCOSE (TYG) INDEX

Abstract

Objective: Background and aim of the study: the triglyceride–glucose (TyG) index, an indirect index of insulin resistance, has been found associated to the development of heart failure (HF). Left ventricular hypertrophy and concentric geometry are associated to the future risk of cardiovascular events, including heart failure Design and method: In 1070 patients undergoing an echocardiogram and laboratory examinations at an ESH Excellence Centre for workup for suspect arterial hypertension (age 56±14 years, 49% males, 75% hypertensives (HT), among them 79% treated) left ventricular mass (LVM) and geometry were assessed. Subjects were divided into 4 LV geometric patterns according to the presence of an increased LV mass index (LVM/h2.7> 47 for females and and > 50 for males) and/or an increased relative wall thickness (RWT> 0.42). Results: After echocardiography subjects were classified as follows: 795(74%) with normal LV geometry (NG), 88 (8%) with concentric remodelling (CR), 143(13%) with eccentric hypertrophy (E_LVH) and 44 (4%) with concentric hypertrophy (C_LVH). The TyG was greater in males, in obese and in diabetic patients, and was significantly correlated with age, BMI, eGFR, systolic and diastolic blood pressure, LVM, LVMI and relative wall thickness. TyG remained significantly greater in patients with C_LVH as compared to both patients with NG and to patients with E_LVH, even after adjusting for multiple possible confounders (TyG: 8.5±0.6, 8.9±0.5, 8.6±0.6 and 9.0±0.7 and in patients with NG, CR, EH and CH respectively, ANOVA p < 0.05). The results did not change after excluding diabetic patients Conclusions: Conclusion: the triglyceride–glucose (TyG) index, an indirect index of insulin resistance is significantly associated to concentric LVH, independently of several possible confounders. These findings can explain at least in part the association between TyG and the risk of cardiovascular events.