Why the study?
Normal glucose-tolerant individuals with 1-h post-load plasma glucose ≥155 mg/dL have impaired cardiometabolic profiles, but subclinical atrial myocardial damage in this population had not been evaluated.
Does a 1-h post-load plasma glucose ≥155 mg/dL during OGTT correlate with subclinical left atrial myocardial dysfunction in hypertensive patients?
Does a 1-h post-load plasma glucose ≥155 mg/dL during OGTT correlate with subclinical left atrial myocardial dysfunction in hypertensive patients?
Hypertensive patients with normal glucose tolerance but 1-h post-load glucose ≥155 mg/dL exhibit early subclinical atrial dysfunction, highlighting atrial myopathy in the pre-diabetes stage.
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Alerts clinicians to atrial remodeling risk in high 1-h glucose NGT; leaves open whether screening improves AF prediction.
BACKGROUND: Recently, studies demonstrated that normal glucose-tolerant subjects (NGT) with 1-h post-load plasma glucose value ≥155 mg/dL during oral glucose tolerance test (OGTT) (NGT ≥ 155) present an impaired cardio-metabolic profile, with subclinical myocardial damage. Atrial morphological and functional alterations, closely related to diastolic dysfunction, are important predictors of atrial fibrillation (AF), cardiovascular (CV) events and mortality in the entire population as well as in diabetic patients. The aim of our study was to evaluate subclinical atrial myocardial damage, assessed with speckle tracking echocardiography, in NGT≥155 mg/dL patients, comparing to NGT < 155 mg/dL subjects, impaired glucose tolerant (IGT) individuals and patients with newly diagnosed type 2 diabetes (T2DM). METHODS: We enrolled 229 Caucasian patients. All subjects underwent anthropometrical and haemodynamic parameters evaluation, OGTT, advanced Colour-Doppler echocardiography with evaluation of main atrial and ventricular parameters. RESULTS: As expected, from first to the fourth group there was a worsening of the metabolic profile as attested by fasting, 1- and 2-h post-load plasma glucose levels, during OGTT. Moreover, from NGT < 155 to T2DM group there was an impairment in reservoir and pump atrial function (PALS and PACS, respectively) (p < .0001). CONCLUSION: Present data demonstrated for the first time that NGT≥155 subjects present subclinical atrial dysfunction. These results may be clinically relevant because they highlight how atrial myopathy occurs early in pre-diabetes stage regardless of fibrotic and morphological alterations of the ventricular myocardium.
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Miceli et al. (2023) studied this question.
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