Impact of Glycemic Control on Left Ventricular Function in Patients with Coronary Artery Disease: A Retrospective Computed Tomography Coronary Angiography Study

Background: The interplay between coronary artery disease (CAD) and left ventricular (LV) function is particularly significant in the context of diabetes, which notably exacerbates cardiac complications.Coronary artery disease can induce LV dysfunction, resulting in both systolic and diastolic impairments.Diabetes accelerates atherosclerosis, thereby intensifying the prevalence and severity of CAD and further compromising LV function.This study aims to investigate how factors such as glycemic control, calcified coronary plaque, and the number of involved coronary vessels influence the relationship between the degree of coronary stenosis and left ventricular function.Materials and methods: Data from 500 patients were retrospectively analyzed using picture archiving and communication system (PACS) from computed tomography (CT) coronary angiography.The correlation between coronary artery stenosis severity (as measured by the Gensini Score) and left ventricular functional parameters, including ejection fraction (EF) and end-diastolic volume (EDV), was examined.Various independent factors, including the calcium score of coronary vessels, the number of affected vessels, and glycemic control, were considered to determine the strength of the correlation between stenosis degree and LV function in the presence of these factors.Results: A negative correlation between the degree of coronary artery stenosis and EF was identified.This correlation was found to strengthen with higher glycated hemoglobin (HbA1c) levels (p < 0.001).The correlation coefficients for groups I, II, and III were -0.324, -0.634, and -0.689, respectively.Multivessel disease was associated with a more pronounced reduction in EF compared to single-vessel or no-vessel disease (p < 0.001).Patients with higher calcium scores (Agatston stage II: >10<100 and stage III: >100<400) exhibited a more substantial negative correlation.Additionally, a negative correlation was observed between coronary artery stenosis and diastolic function, with a stronger relationship in the presence of elevated HbA1c and multivessel involvement; however, the calcium score showed no significant effect.Conclusion: Poor glycemic control has a detrimental impact on left ventricular function in patients with CAD.Other independent factors, such as calcium score and the number of affected vessels, also exacerbate the negative correlation between the degree of coronary artery stenosis and LV function.