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The association between insulin resistance and diastolic dysfunction of lft ventricle in essential hypertensives
Marn-Pernat, Andreja ...
Left ventricular diastolic dysfunction is one of the earliest changes of the heart in developing hypertension. The pathophysiological mechanisms that are taking part in altered cardiac diastolic ...function in the patients with essential hypertension are not fully elucidated. Insulin resistance and compensatory hyperinsulinemia are said to be associated with essential hypertension. The purpose of this study was to investigate the relationship ofvariables of insulin metabolism to cardiac diastolic function assessed by pulsed Doppler technique. Forty-one patients with untreated borderline to mildessential hypertension and 24 healthy subjects participated in the study. Only men were included. They had normal glucose tolerance. Hypertensives were older and had higher body mass index, systolic and diastolic blood pressure. All subjects underwent a 75-g oral glucose tolerance test and blood samples were obtained 30, 60 and 120 minutes thereafter for the determination of insulin concentrations which were measured by radioimmunoassay. Integrated response of insulin to the glucose load was calculated as the area under the curve. Insulin resistance was defined by an elevated value of the ratio of thearea under the curve of insulin and glucose. We chose pulsed Doppler echocardiography to assess cardiac diastolic function. The ratio of early to late transmitral peak flow velocity (E/A ratio) was used as the index of left ventricular diastolic filling. (Abstract truncated at 2000 characters.)
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