open access

Vol 22, No 2 (2015)
Original articles
Published online: 2015-04-28
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Left ventricular filling pressure in male patients with type 2 diabetes and normal versus low total testosterone levels

Matias Tinetti, Michael Gysel, Javier Farias, Mariano Ferrer, Martin Lombardero, Adrian Baranchuk
DOI: 10.5603/CJ.a2014.0056
·
Pubmed: 25179319
·
Cardiol J 2015;22(2):206-211.

open access

Vol 22, No 2 (2015)
Original articles
Published online: 2015-04-28

Abstract

Background: Heart failure is a common complication of diabetes characterized by an elevation in left ventricular filling pressures (LVF) that often develops in the absence of clinical symptoms. Diastolic dysfunction in the setting of low total testosterone (LTT) occurs through changes in the regulation of peripheral hemodynamics. LTT is highly prevalent among individuals with type 2 diabetes. The aim of this study was to compare LVF in male diabetic pa­tients with no structural heart disease and normal serum testosterone levels vs. those with LTT.

Methods: Type 2 diabetic patients were assessed using tissue Doppler imaging to evalu­ate LVF and other conventional parameters of diastolic function. The E/e’ ratio was used to estimate LVF through the ratio of peak passive trans-mitral left ventricular inflow velocity to the peak passive inflow velocity at the lateral mitral annulus. Patients were assigned to one of two groups based upon their total testosterone levels. Group A consisted of low (< 3.5 ng/mL) testosterone levels and group B consisted of normal (> 3.5 ng/mL) testosterone levels.

Results: A total of 148 male patients were included: group A — 47 (32%) patients; group B — 101 (68%) patients, respectively. Mean age was 58 ± 5.8 years and mean time of diabetes evolution was 7 ± 3.1 years. There were no significant differences between the groups regarding age, duration of diabetes evolution, hypertension, weight, heart rate, body mass index, and echocardiographic parameters. The E/e’ ratio for group A was 8.05 ± 1.9 vs. 6.1 ± 1.7 for group B (p < 0.0001). The E/A ratio was 0.94 ± 0.10 vs. 1.19 ± 0.12 (p = 0.01), deceleration time 242 ± 7.4 ms vs. 205 ± 9 ms (p = 0.026) and systolic pulmonary artery pressure 27 ± ± 2.2 mm Hg vs. 22 ± 1.7 mm Hg (p = 0.11).

Conclusions: Patients with type 2 diabetes and LTT have a higher E/e’ ratio demonstrating a pre-clinical increase in LVF when compared to similar patients with normal testosterone levels. This finding is independent of time of diabetes evolution, hypertension and other echocardiographic parameters.

Abstract

Background: Heart failure is a common complication of diabetes characterized by an elevation in left ventricular filling pressures (LVF) that often develops in the absence of clinical symptoms. Diastolic dysfunction in the setting of low total testosterone (LTT) occurs through changes in the regulation of peripheral hemodynamics. LTT is highly prevalent among individuals with type 2 diabetes. The aim of this study was to compare LVF in male diabetic pa­tients with no structural heart disease and normal serum testosterone levels vs. those with LTT.

Methods: Type 2 diabetic patients were assessed using tissue Doppler imaging to evalu­ate LVF and other conventional parameters of diastolic function. The E/e’ ratio was used to estimate LVF through the ratio of peak passive trans-mitral left ventricular inflow velocity to the peak passive inflow velocity at the lateral mitral annulus. Patients were assigned to one of two groups based upon their total testosterone levels. Group A consisted of low (< 3.5 ng/mL) testosterone levels and group B consisted of normal (> 3.5 ng/mL) testosterone levels.

Results: A total of 148 male patients were included: group A — 47 (32%) patients; group B — 101 (68%) patients, respectively. Mean age was 58 ± 5.8 years and mean time of diabetes evolution was 7 ± 3.1 years. There were no significant differences between the groups regarding age, duration of diabetes evolution, hypertension, weight, heart rate, body mass index, and echocardiographic parameters. The E/e’ ratio for group A was 8.05 ± 1.9 vs. 6.1 ± 1.7 for group B (p < 0.0001). The E/A ratio was 0.94 ± 0.10 vs. 1.19 ± 0.12 (p = 0.01), deceleration time 242 ± 7.4 ms vs. 205 ± 9 ms (p = 0.026) and systolic pulmonary artery pressure 27 ± ± 2.2 mm Hg vs. 22 ± 1.7 mm Hg (p = 0.11).

Conclusions: Patients with type 2 diabetes and LTT have a higher E/e’ ratio demonstrating a pre-clinical increase in LVF when compared to similar patients with normal testosterone levels. This finding is independent of time of diabetes evolution, hypertension and other echocardiographic parameters.

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Keywords

diabetes, left ventricular filling pressures, total testosterone, heart failure

About this article
Title

Left ventricular filling pressure in male patients with type 2 diabetes and normal versus low total testosterone levels

Journal

Cardiology Journal

Issue

Vol 22, No 2 (2015)

Pages

206-211

Published online

2015-04-28

DOI

10.5603/CJ.a2014.0056

Pubmed

25179319

Bibliographic record

Cardiol J 2015;22(2):206-211.

Keywords

diabetes
left ventricular filling pressures
total testosterone
heart failure

Authors

Matias Tinetti
Michael Gysel
Javier Farias
Mariano Ferrer
Martin Lombardero
Adrian Baranchuk

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