scholarly journals Diabetes reduces left ventricular ejection fraction-irrespective of presence and extent of coronary artery disease

2011 ◽  
Vol 165 (6) ◽  
pp. 945-951 ◽  
Author(s):  
Niklas F Ehl ◽  
Michael Kühne ◽  
Miriam Brinkert ◽  
Jan Müller-Brand ◽  
Michael J Zellweger
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Diabetic Patients ◽  
Ventricular Ejection Fraction ◽  
Artery Disease

BackgroundIt is not clear whether diabetes reduces systolic left ventricular function (left ventricular ejection fraction, LVEF) irrespective of coronary artery disease (CAD). The aim of this study was to compare the LVEF between diabetic and non-diabetic patients with respect to the extent of CAD.Methods and resultsConsecutive patients undergoing stress myocardial perfusion SPECT (MPS) were evaluated. MPS was interpreted using a 20-segment model with a five-point scale to define summed stress score (SSS), summed rest score, and summed difference score. LVEF was measured by gated SPECT and then compared with respect to diabetic status and SSS categories. Of 2635 patients, data of 2400 was available. Of these, 24% were diabetic, mean age was 64±11y, and 31% were female. Diabetics had a significantly lower LVEF compared with non-diabetics regardless of the extent of CAD: 53±13 and 55±13% respectively (P=0.001). Diabetics and non-diabetics did not differ significantly in the distribution of SSS categories. Diabetes was an independent predictor of decreased LVEF (odds ratio 1.6, 95% confidence interval 1.2–2.0; P<0.001).ConclusionDiabetics had a lower LVEF than non-diabetics. This difference could be demonstrated regardless of CAD extent and might in part explain their generally worse cardiac survival compared with non-diabetics on an epidemiological level. In addition, this finding points to discussed mechanisms other than CAD lowering LVEF in diabetics.

Relation of the Ankle Brachial Index to Left Ventricular Ejection Fraction in Patients Without Coronary Artery Disease

Cardiology ◽  
2018 ◽  
Vol 141 (1) ◽  
pp. 18-24
Author(s):  
Arismendy Nunez ◽  
Sophia Russ ◽  
Muhammad Ihsan ◽  
Sarah Gaballah ◽  
Attiya Haque ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Ankle Brachial Index ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Artery Disease

Background: The low ankle brachial index (ABI) values are indicative of peripheral arterial disease, but have recently been found to be associated with reduced left ventricular ejection fraction (LVEF). This may relate to coexisting coronary artery disease (CAD). Aim: This study prospectively assessed a potential ABI–LVEF association in patients without CAD. Methods and Results: We studied 55 patients (age 57 ± 13 years, 49% male) with normal coronary arteries with LVEF determination. ABI, pulse wave velocity (PWV), and augmentation index (AI) were performed after coronary angiography. ABI correlated with LVEF (r = 0.40, p = 0.002), but not with PWV or AI. On linear regression analysis, ABI was independently associated with LVEF (B = 0.42, p = 0.004). The median LVEF was lower in subjects with low ABI values compared to those with normal ABI values (33 vs. 61%; p = 0.001). Conclusion: ABI may be influenced by LVEF independently of CAD, arterial stiffness or pressure wave reflection.

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