Key result
Higher TyG index linked to LV global longitudinal strain defects in young hypertensive patients.
Why the study?
Cardiac remodeling increases cardiovascular risk in hypertension and may stem from metabolic disorders alongside hemodynamic causes, prompting evaluation of insulin resistance associations with left ventricular remodeling in young patients.
Does insulin resistance increase the risk of early left ventricular remodeling and systolic dysfunction in young patients with hypertension?
Cross-Sectional (n=105)
No
Does insulin resistance increase the risk of early left ventricular remodeling and systolic dysfunction in young patients with hypertension?
Insulin resistance, particularly as measured by the TyG index, is associated with early subclinical left ventricular systolic dysfunction in young hypertensive patients.
Answers are grounded in this paper and cite their sources.
May signal early LV dysfunction in young hypertensives; leaves open whether TyG improves risk stratification beyond standard measures.
Cardiac remodeling refers to factors that increase the risk of cardiovascular events in patients with hypertension (HTN). Changes in myocardial structure and function can be caused not only by hemodynamic causes, but also a number of metabolic disorders. Aim. To analyze the associations of insulin resistance and left ventricular (LV) remodeling in a cohort of young patients with untreated uncomplicated hypertension and high normal blood pressure (BP). Material and methods. The presented cohort cross-sectional study included 105 subjects. We analyzed clinical, demographic and anthropometric characteristics, performed a biochemical panel (creatinine, potassium, lipid profile, glucose, insulin, uric acid) with the estimation of insulin resistance scores (HOMA-IR, METs-IR, TyG), a glycosylated hemoglobin test. Urine albumin-to-creatinine ratio was determined. Office and 24-hour ambulatory BP measurement and two-dimensional speckletracking echocardiography were performed in all patients. Results. The median age was 23 years (men — 85%); 51% of participants were overweight or obese, 39% had dyslipidemia, 21% — insulin resistance. Signs of LV remodeling were observed in 38 (40%) subjects: 32 (34%) — concentric remodeling, 5 (5%) — concentric LV hypertrophy (LVH), 1 (1%) — eccentric LVH. Defects of LV systolic global longitudinal strain (GLS) were observed in 44 (47%) young patients with HTN and preHTN. Stepwise multivariate regression analysis revealed that the TyG index was an independent predictor of LV GLS defects (b=0,38, p=0,001). Conclusion. In a cohort of young patients with HTN and high normal blood pressure, there is a high prevalence of insulin resistance, metabolic disorders, and early signs of LV remodeling and subclinical systolic dysfunction. The TyG index, available for estimation by routine biochemical tests, is an independent factor affecting the LV GLS.
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Shavarova et al. (2020) conducted a cross-sectional in Hypertension and high normal blood pressure (n=105). Insulin resistance (assessed by TyG index, HOMA-IR, METs-IR) vs. Normal insulin sensitivity was evaluated on Defects of LV systolic global longitudinal strain (GLS) (b=0.38, p=0.001). The TyG index, an indicator of insulin resistance, was an independent predictor of left ventricular global longitudinal strain defects in young patients with hypertension or high normal blood pressure (b=0.38, p=0.001).
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