Myocardial mechano-energetic efficiency and insulin resistance in non-diabetic members of the Strong Heart Study cohort

作者：Costantino Mancusi, Giovanni de Simone, Lyle G. Best, Wenyu Wang, Ying Zhang, Mary J. Roman, Elisa T. Lee, Barbara V. Howard, Richard B. Devereux · 发表于：Cardiovascular Diabetology · 年份：2019 · DOI：10.1186/s12933-019-0862-9 · 被引用次数：93 · 研究领域：Cardiovascular Function and Risk Factors、Heart Rate Variability and Autonomic Control、Cardiac Imaging and Diagnostics

Abstract Background Myocardial energetic efficiency (MEE), is a strong predictor of CV events in hypertensive patient and is reduced in patients with diabetes and metabolic syndrome. We hypothesized that severity of insulin resistance (by HOMA-IR) negatively influences MEE in participants from the Strong Heart Study (SHS). Methods We selected non-diabetic participants (n = 3128, 47 ± 17 years, 1807 women, 1447 obese, 870 hypertensive) free of cardiovascular (CV) disease, by merging two cohorts (Strong Heart Study and Strong Heart Family Study, age range 18–93). MEE was estimated as stroke work (SW = systolic blood pressure [SBP] × stroke volume [SV])/“double product” of SBP × heart rate (HR), as an estimate of O2 consumption, which can be simplified as SV/HR ratio and expressed in ml/sec. Due to the strong correlation, MEE was normalized by left ventricular (LV) mass (MEEi). Results Linear trend analyses showed that with increasing quartiles of HOMA-IR patients were older, more likely to be women, obese and hypertensive, with a trend toward a worse lipid profile (all p for trend < 0.001), progressive increase in LV mass index, stroke index and cardiac index and decline of wall mechanics (all p < 0.0001). In multivariable regression, after adjusting for confounders, and including a kinship coefficient to correct for relatedness, MEEi was negatively associated with HOMA-IR, independently of significant associations with age, sex, blood pressure, lipid profile and central obesit...