The relationship between left ventricular diastolic dysfunction and hemoglobin A1c levels in the type 2 diabetes mellitus patient population

Abstract

Objectives: This study aimed to investigate the relationship between hemoglobin A1c (HbA1c) levels, which is a good marker for determining glycemic levels, and left ventricular diastolic dysfunction (LVDD) in the type 2 diabetes mellitus (DM) patient population. Patients and methods: This retrospective study was conducted with 116 type 2 DM patients (62 males, 54 females; mean age: 58.4±9.5 years; range, 18 to 65 years) between July 2019 and November 2021. The patients were divided into two groups as those without LVDD (n=55, Group 1) and those with LVDD (n=61, Group 2). Early to late diastolic transmural flow velocity (E/A) ratio, the mean ratio (E/e') of mitral inflow (E) and mitral annular (e'), HbA1c levels, other hemogram and biochemical parameters, and demographic data were recorded. Results: The HbA1c level was significantly higher in the group with LVDD (6.96±1.23 vs. 9.00±2.19, p<0.001). While the mean E/e' ratio was 9.69±2.73 in the group without LVDD, it was 16.00±1.69 in the group with LVDD, and there was a significant difference between the two groups (p<0.001). The mean E/A ratio was significantly higher in the group without LVDD (1.25±0.51 vs. 1.02±0.53, p=0.021). In regression operating characteristics analysis, a HbA1c cut-off value of 7.35 and was found to be a predictor of LVDD in the type 2 DM patient group with a sensitivity of 80% and specificity of 80% (AUC: 0.805; 95% confidence interval: 0.718-0.892; p<0.001). Conclusion: Providing close glycemic follow-up and monitoring the HbA1c level can reduce heart failure and other comorbid conditions that may develop, particularly after LVDD.