Abstract
Abstract Background Cardiovascular diseases represent the leading cause of mortality worldwide. Ischemic heart disease is one of the main causes of diastolic heart failure and its presence predicts a poor prognosis in ischemic heart patients. Most cardiovascular diseases can be prevented by addressing behavioral risk factors such as overweight and obesity. Leptin –also known as satiety hormone- helps in inhibiting hunger and regulate energy balance (1). Objective to correlate leptin level with ischemic heart disease with or without diastolic dysfunction by comparing it in lean and obese patients. Material and Methods from June 2019 to November 2019, 140 ischemic patients documented with CA, MSCT or history of PCI AND 35 Control subjects were enrolled from both Ain Shams University, Cardiology department wards and outpatient clinic and Misr University for science and technology, cardiology department wards and outpatient clinic. All participants subjected to history, clinical examination, Duke CAD index to estimate the severity of ischemia, calculation of their BMI, blood sampling for measuring their serum leptin level and echocardiography for detecting the diastolic function. Patients were divided into four groups according to their BMI and Diastolic function in addition to the control group. Groups were demonstrated as follow Group A lean ischemic patients without significant diastolic dysfunction, Group B lean ischemic patients with diastolic dysfunction (II-IV), Group C obese ischemic patients without significant diastolic dysfunction, Group D obese ischemic patients with diastolic dysfunction(II-IV), Group E is a control group lean non ischemic without diastolic dysfunction . Results There were significant positive correlations between serum leptin and Duke score in all ischemic groups (n = 140) (p < 0.001). Serum leptin abnormality was significantly more frequent in diastolic dysfunction groups (n = 70) than in non-dysfunction groups (N = 70) (Group B 25.7%, group D 28.6% vs group A 5.7% group C 8.6%, also was lowest in control group (n = 35) 0.0%. serum leptin was significantly positive correlated with ischemia as in group A17.8±2.1ng/mL group B 23.4±11.1ng/mL group C 55.4±10.9 ng/mL group D 65.2±10.8 ng/mL vs control group E 13.1±2.7 ng/mL. Conclusion leptin is an independent risk factor for coronary heart disease. Also elevated plasma leptin levels are associated with impaired left ventricular diastolic function in patients with CAD independently of obesity and other confounding variables.
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