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Is insulin resistance related to cardiac diastolic function in hypertensives?
Marn-Pernat, Andreja ...
Recent studies indicate that, inslin resistance and compensatory hyperinsulinemia both contribute to the pathogenesis of essential hypertension. Cardiac diastolic dysfunction may be the earliest ...indicator of hypertensive heart disease. Factors that influence disastolic dysfunction in hypertensives are not celar. It has not been shown yet whether insulin resistance and hyperinsulinemia might be enrolled in diastolic abnormalities. The purpose of this study is to evaluate the relationship of insulin metabolism to cardiac diastolic function in patients with hypertension. Nineteen hyperte4nsive, nondiabetic men were included in the hypertensive group. Eleven healthy volunteers served as the control group. C-peptide, fasting insulin and insulin concentrations during the oral glucose tolerance test were determined by radioimmunoassay. Fasting glucose/insulin ratio used as the index of insulin resistence. M-mode, two-dimensional and pulsed-wave Doppler echocardiograms were recorded in all subjects. The ratio of early to late transmitral peak flow velocity (E/A) was used to evaluate left ventricular diastolic filling. The hypertensive group had higher fasting insulin concentrations and a lower glucose/insulin index. Patients with hypertension also seemed to have a lower E/A ratio. We found the E/A ratio to be closely associated with glucose/insulin index and C-peptide concentrations. Therefore we suggest that insulin resistance is better predictor of diastolic dysfunction in comparison to insulinemia.
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