PMID- 28818638
OWN - NLM
STAT- MEDLINE
DCOM- 20181126
LR  - 20221207
IS  - 2241-5955 (Electronic)
IS  - 1109-9666 (Linking)
VI  - 59
IP  - 2
DP  - 2018 Mar-Apr
TI  - Association of hemoglobin A1c variability and the incidence of heart failure with 
      preserved ejection fraction in patients with type 2 diabetes mellitus and 
      arterial hypertension.
PG  - 91-97
LID - S1109-9666(17)30234-8 [pii]
LID - 10.1016/j.hjc.2017.08.001 [doi]
AB  - BACKGROUND: This study aimed to investigate the association between variability 
      in hemoglobin A1c (HbA1c) and left ventricular (LV) diastolic function and 
      incidence of symptomatic heart failure with preserved ejection fraction (HFpEF) 
      in patients with type 2 diabetes mellitus (T2DM) and arterial hypertension. 
      METHODS: A retrospective cohort study was conducted on eligible patients with 
      T2DM and hypertension and without clinical signs or symptoms of heart failure in 
      our hospital medical record database. Variability in HbA1c was measured by 
      standard deviation (SD) and coefficient of variation (CV). Risk of new onset of 
      symptomatic HFpEF was evaluated by multivariable cox regression analysis. 
      RESULTS: A total of 201 subjects were categorized according to the median value 
      of HbA1c variability indicators. Over a median follow-up of 7.3 years, the 
      percentage of subjects who had new incidence of symptomatic HFpEF was higher in 
      those with higher HbA1c-SD level (5/105 vs. 13/96, P=0.029) and higher HbA1c-CV 
      level (5/101 vs. 13/100, P=0.046). Multivariable cox regression analysis also 
      showed that higher HbA1c variability [HbA1c-SD (HR 1.754, 95% CI: 1.003-3.104, 
      P=0.049) or HbA1c-CV (HR 1.604 95% CI: 1.064-2.419, P=0.024)] was associated with 
      the presence of new-onset symptomatic HFpEF, independent of HbA1c-mean level, in 
      T2DM and hypertensive patients. Moreover, lower HbA1c variability generated more 
      prominent improvement in LV diastolic function (E/E') during the follow-up. 
      CONCLUSIONS: HbA1c variability may provide additional valuable information as a 
      potential predictor of the progression of HFpEF in T2DM and hypertensive 
      patients.
CI  - Copyright (c) 2018 Hellenic Society of Cardiology. Published by Elsevier B.V. All 
      rights reserved.
FAU - Gu, Jun
AU  - Gu J
AD  - Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiaotong 
      University School of Medicine, Shanghai, People's Republic of China. Electronic 
      address: forrestgu@126.com.
FAU - Fan, Yu-Qi
AU  - Fan YQ
AD  - Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiaotong 
      University School of Medicine, Shanghai, People's Republic of China.
FAU - Zhang, Jun-Feng
AU  - Zhang JF
AD  - Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiaotong 
      University School of Medicine, Shanghai, People's Republic of China.
FAU - Wang, Chang-Qian
AU  - Wang CQ
AD  - Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiaotong 
      University School of Medicine, Shanghai, People's Republic of China. Electronic 
      address: shhpxys@sina.com.
LA  - eng
PT  - Journal Article
DEP - 20170815
PL  - Netherlands
TA  - Hellenic J Cardiol
JT  - Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese
JID - 101257381
RN  - 0 (Glycated Hemoglobin A)
SB  - IM
MH  - Aged
MH  - China/epidemiology
MH  - Diabetes Mellitus, Type 2/blood/*complications
MH  - Female
MH  - Follow-Up Studies
MH  - Glycated Hemoglobin/*metabolism
MH  - Heart Failure/*epidemiology/etiology/physiopathology
MH  - Humans
MH  - Hypertension/*complications/physiopathology
MH  - Incidence
MH  - Male
MH  - Retrospective Studies
MH  - Stroke Volume/*physiology
MH  - Ventricular Function, Left/*physiology
OTO - NOTNLM
OT  - diastolic function
OT  - heart failure with preserved ejection fraction
OT  - hemoglobin A1c variability
OT  - hypertension
OT  - type 2 diabetes mellitus
EDAT- 2017/08/19 06:00
MHDA- 2018/11/27 06:00
CRDT- 2017/08/19 06:00
PHST- 2017/05/10 00:00 [received]
PHST- 2017/07/19 00:00 [revised]
PHST- 2017/08/02 00:00 [accepted]
PHST- 2017/08/19 06:00 [pubmed]
PHST- 2018/11/27 06:00 [medline]
PHST- 2017/08/19 06:00 [entrez]
AID - S1109-9666(17)30234-8 [pii]
AID - 10.1016/j.hjc.2017.08.001 [doi]
PST - ppublish
SO  - Hellenic J Cardiol. 2018 Mar-Apr;59(2):91-97. doi: 10.1016/j.hjc.2017.08.001. 
      Epub 2017 Aug 15.