Background Left ventricular diastolic dysfunction (LVDD) is a prevalent and early echocardiographic derangement in diabetic cardiomyopathy. Data are limited regarding the association between impaired fasting glucose (IFG) and LVDD. We evaluated weather IFG is associated with LVDD among middle age adults. Methods Study population comprised 2,971 subjects without LV systolic dysfunction or valvular heart disease who were annually screened in a health survey in a tertiary hospital. Subjects were categorized into three groups: euglycemia (N=2,025), IFG (N=534) and Diabetes Mellitus (DM; N=412). All subjects underwent Doppler echocardiography by readers blinded to their glycemic state. Subjects with impaired left ventricular relaxation, pseudo-normal or restrictive filling patterns were defined as having LVDD. Results Mean age of study population was 59±12 years and 75% were men. LVDD was diagnosed in 574 (19%) subjects and was more common among subjects with IFG and DM than among euglycemic subjects (27%, 30%, and 15%, respectively; p<0.001), data presented in Figure 1. Compared with euglycemic subjects, those with IFG and DM had lower ratios of early (E) wave to late (A) trans-mitral flow (0.9±0.3 and 0.9±0.3 vs. 1.1±0.4, respectively, p<0.001). LV hypertrophy (LVH) was also more prevalent (11% and 18% respectively, vs. 9%; p<0.001). Multivariate binary logistic regression model adjusted to age, gender, obesity, LVH, renal function and hypertension showed that subjects with IFG were 46% more likely to have LVDD compared with euglycemic subjects (95% CI [1.14-1.87], p=0.003). Subgroup analysis showed that the association between IFG and LVDD was more pronounced in younger subjects (age ≤ 59years) and among those without treated hypertension. Conclusions IFG is associated with LVDD among middle age adults, this association is independent of ventricular anatomical abnormalities. Our findings support early evaluation of diastolic function in this population.
