Abstract
Background
Cardiovascular risk factors are classically associated with coronary atherosclerosis. We sought to investigate whether risk factors are also associated with left ventricular (LV) dilatation, contractile impairment and reduced myocardial blood flow (MBF) in patients with non-ischemic LV dysfunction.
Methods
We studied 81 patients (59 males, age 60 ± 9 years) with mild-to-severe LV dysfunction (mean ejection fraction 37%, range 19%-50%), no history of diabetes and normal coronary arteries. Absolute MBF was measured by positron emission tomography and 13N-ammonia at rest and after dipyridamole (0.56 mg/kg I.V. over 4 min).
Results
Overt LV dysfunction (LV end-diastolic diameter >60 mm associated with LV ejection fraction <45%) was present in 42 patients (52%); severely depressed hyperemic MBF (<1.09 mL · min−1 · g−1) was present in 41 patients (51%). Using multivariate logistic regression analysis, low high-density lipoprotein cholesterol (HDL-C, P < .036), newly diagnosed non-insulin-dependent diabetes or insulin-resistance (NIDD/IR, P < .019) and the use of diuretics (P = .001) were independently associated with overt LV dysfunction. Low HDL-C (P = .015) and NIDD/IR (P = .048) were also independently associated with severely depressed hyperemic MBF.
Conclusions
Low HDL-C and NIDD/IR are associated with more severe LV impairment and reduced hyperemic MBF in non-ischemic LV dysfunction.
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Acknowledgments
We thank Elisa Rizza and Stefano Masi for helping collecting the data. We also thank Silvia Pardini and Danilo Bonora for the production of 13N-Ammonia and Alison Frank for helping editing the manuscript. This study was partly supported by the Genocor FIRB 2005 project of the Italian Ministry of Education, University and Research (Grant N. RBLA05ACJZ).
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The authors have indicated that they have no financial conflicts of interest.
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Neglia, D., Sampietro, T., Vecoli, C. et al. Abnormal glucose and lipid control in non-ischemic left ventricular dysfunction. J. Nucl. Cardiol. 19, 1182–1189 (2012). https://doi.org/10.1007/s12350-012-9609-7
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DOI: https://doi.org/10.1007/s12350-012-9609-7