Table 3.
Association of Number of Uncontrolled Metabolic Risk Factors and Echocardiographic Findings
| Control Group | Type 2 Diabetes Mellitus and | P Value (Across All Groups) | P Value (Control vs 0 Risk Factors) | P Value (Control vs 1 to 2 Risk Factors) | P Value (Control vs ≥3 Risk Factors) | |||
|---|---|---|---|---|---|---|---|---|
| 0 Uncontrolled Risk Factors | 1 to 2 Uncontrolled Risk Factors | ≥3 Uncontrolled Risk Factors | ||||||
| n=80 | n=57 | n=349 | n=345 | |||||
| Structural measures | ||||||||
| Left ventricular mass index, g/m2.7 | 35.5 (8.0) | 35.5 (9.6) | 37.1 (11.7) | 41.1 (11.1) | <0.001a | 0.99 | 0.26 | <0.001a |
| Interventricular septum thickness, mm | 10.0 (1.3) | 9.9 (1.4) | 10.4 (1.8) | 11.2 (1.7) | <0.001a | 0.87 | 0.06 | <0.001a |
| End‐diastolic internal diameter, mm | 46.8 (4.8) | 46.0 (6.8) | 45.6 (6.3) | 45.9 (6.0) | 0.51 | 0.43 | 0.13 | 0.21 |
| Posterior wall thickness, mm | 9.4 (1.3) | 9.5 (1.2) | 10.1 (1.5) | 10.8 (1.6) | <0.001a | 0.76 | <0.001a | <0.001a |
| Relative wall thickness | 0.41 (0.07) | 0.42 (0.07) | 0.45 (0.09) | 0.48 (0.10) | <0.001a | 0.26 | <0.001a | <0.001a |
| Sphericity index | 0.17 (0.02) | 0.17 (0.02) | 0.18 (0.03) | 0.18 (0.03) | 0.17 | 0.60 | 0.11 | 0.05a |
| Left atrial end‐systolic volume index, mL/m2 | 26 [22, 32] | 26 [21, 31] | 25 [20, 32] | 25 [20, 31] | 0.81 | 0.82 | 0.79 | 0.56 |
| Diastolic measures | ||||||||
| Peak E velocity, m/s | 0.67 [0.55, 0.78] | 0.74 [0.63, 0.87] | 0.75 [0.63, 0.87] | 0.76 [0.65, 0.88] | <0.001a | 0.01a | <0.001a | <0.001a |
| Peak A velocity, m/s | 0.60 (0.16) | 0.79 (0.19) | 0.85 (0.19) | 0.86 (0.20) | <0.001a | <0.001a | <0.001a | <0.001a |
| E/A ratio | 1.11 [0.85, 1.38] | 0.94 [0.80, 1.08] | 0.86 [0.75, 1.07] | 0.87 [0.75, 1.06] | <0.001a | 0.005a | <0.001a | <0.001a |
| E deceleration time, ms | 191 [164, 219] | 209 [168, 247] | 220 [183, 263] | 220 [188, 269] | <0.001a | 0.14 | <0.001a | <0.001a |
| Lateral e′ (per second) | 10.8 (3.5) | 9.6 (2.5) | 8.7 (2.6) | 8.5 (2.5) | <0.001a | 0.03a | <0.001a | <0.001a |
| Septal e′, m/s | 8.4 (2.7) | 7.2 (1.8) | 6.8 (1.9) | 6.5 (1.8) | <0.001a | 0.002a | <0.001a | <0.001a |
| E/e′lateral | 6.3 [4.9, 7.8] | 7.7 [6.5, 10.2] | 8.6 [6.9, 10.6] | 9.0 [7.2, 12.1] | <0.001a | <0.001a | <0.001a | <0.001a |
| E/e′septal | 7.7 [6.6, 9.9] | 10.5 [8.6, 12.4] | 10.9 [9.2, 13.3] | 11.6 [9.6, 14.9] | <0.001a | <0.001a | <0.001a | <0.001a |
| Systolic measures | ||||||||
| Ejection fraction, % | 61 [56, 65] | 62 [57, 66] | 61 [57, 65] | 60 [55, 65] | 0.14 | 0.52 | 0.96 | 0.24 |
| Reduced ejection fraction (<50%), % | 5 (6.5) | 2 (3.6) | 34 (9.9) | 48 (14.4) | 0.03a | 0.73 | 0.48 | 0.09 |
| Global longitudinal systolic strain, % | −15.9 (2.0) | −15.3 (2.4) | −14.6 (2.8) | −14.0 (2.8) | <0.001a | 0.13 | <0.001a | <0.001a |
| Global longitudinal systolic strain rate (per second) | −0.81 (0.11) | −0.80 (0.14) | −0.79 (0.17) | −0.77 (0.18) | 0.09 | 0.53 | 0.37 | 0.04a |
| Global circumferential systolic strain, % | −18.1 (4.1) | −18.7 (4.8) | −18.0 (5.2) | −17.4 (5.3) | 0.34 | 0.49 | 0.87 | 0.35 |
| Global circumferential systolic strain rate (per second) | −0.97 (0.22) | −0.99 (0.28) | −1.05 (0.33) | −1.03 (0.34) | 0.27 | 0.71 | 0.07 | 0.19 |
Criteria for uncontrolled metabolic risk factors include hemoglobin A1c >48 mmol/L, systolic blood pressure >140 mm Hg, body mass index >30 kg/m2, HDL‐cholesterol <1.0 mmol/L for women and <0.9 mmol/L for men, triglyceride >1.7 mmol/L, and presence of micro‐ or macroalbuminuria. Continuous traits are reported as mean (SD) or median [interquartile range] in case of nonnormal distribution. A indicates atrial diastolic mitral inflow velocity; E, early diastolic mitral inflow velocity; e′, early diastolic myocardial velocity at the level of the mitral annulus.
a
P<0.05.