OS 27-06 INDEPENDENT PROGNOSTIC VALUE OF LEFT VENTRICULAR MASS, DIASTOLIC FUNCTION, AND FASTING PLASMA GLUCOSE

Abstract

Objective: To explore the independent prognostic value of left ventricular (LV) mass, diastolic function, and fasting plasma glucose (FPG) for the prediction of incident cardiac events in a random population sample. Design and Method: 415 women and 999 men aged 56–79 years, included between 2002-2006, underwent echocardiography based on groups defined by FPG, i.e. normal (NFG): FPG ≤ 6.0 mmol/L; impaired (IFG): FPG 6.1–6.9 mmol/L; and diabetes mellitus (DM): FPG ≥ 7.0 mmol/L, self-reported DM, and/or on anti-diabetic drugs. Additive prognostic value of FPG category and echocardiography (LV mass index (LVMI), LV hypertrophy (LVH), averaged E/e, and diastolic function graded as normal, grade 1, or grade 2 + 3 diastolic dysfunction) to a prediction model with traditional cardiovascular (CV) risk factors was assessed using Cox proportional hazards regression. Cardiac events were defined as myocardial infarction, coronary revascularization, or heart failure. Results: 37 % were classified as NFG, 26 % as IFG, and 37 % as DM. Median LVMI and E/e were 86 [74–102] g/m2 and 8 [6–10], respectively. Over a median follow-up time of 7.8 [7.2–8.7] years, 181 events occurred. The simple prediction model included age, gender, systolic blood pressure, heart rate, previous CV disease, and use of CV medication. Addition of averaged E/e (likelihood-ratio c2 11.69, p Conclusions: LVMI and E/e, but not FPG category provided additional adverse prognostic value on top of traditional CV risk factors. The combination of both glucometabolic and echocardiographic abnormalities was associated with a progressively greater risk of cardiac events.