Left ventricular hypertrophy (LVH) and the insulin resistance syndrome are common conditions associated with a markedly increased cardiovascular risk. In a fairly large prospective longitudinal study of men from the general population, we found that an unfavorable serum fatty acid profile and components of the insulin resistance syndrome such as dyslipidemia, obesity and hypertension at age 50 predicted the prevalence of LVH at age 70. In cross-sectional analyses at age 70, several components of the insulin resistance syndrome were significantly related to left ventricular relative wall thickness and concentric remodeling, but less to LVH. Left ventricular relative wall thickness was inversely related to insulin sensitivity in skeletal muscle and borderline significantly directly related to insulin sensitivity in the myocardium in a healthy, normotensive sample of the cohort investigated with positron emission tomography, whereas left ventricular mass index was not related to myocardial or skeletal muscle insulin sensitivity…
Contents
INTRODUCTION
THE ETIOLOGY OF LEFT VENTRICULAR HYPERTROPHY
LEFT VENTRICULAR HYPERTROPHY AND THE INSULIN RESISTANCE SYNDROME
ELECTROPHYSIOLOGIC CO-MORBIDITY OF LEFT VENTRICULAR HYPERTROPHY
PROGNOSTIC SIGNIFICANCE OF LEFT VENTRICULAR HYPERTROPHY
AIMS OF THE STUDY
METHODS
THE COHORT
Study populations
INVESTIGATIONS AT AGE 50
INVESTIGATIONS AT AGE 70
Echocardiography
Electrocardiography
Blood pressure measurements
Hyperinsulinemic euglycemic clamp
Oral glucose tolerance tes
Lipid measurements
Positron emission tomography
FOLLOW-UP AFTER AGE 70
STATISTICAL ANALYSIS
RESULTS
STUDY
DISCUSSION
LEFT VENTRICULAR HYPERTROPHY AND THE INSULIN RESISTANCE SYNDROME
Components of the insulin resistance syndrome are risk factors for later left ventricular hypertrophy
Fatty acids and left ventricular hypertrophy
Relative wall thickness is related to components of the insulin resistance syndrome
Relative wall thickness is related to skeletal muscle insulin resistance
INSULIN RESISTANCE AND LEFT VENTRICULAR HYPERTROPHY: CAUSE OR CONSEQUENCE?
Potential mechanisms whereby insulin resistance or hyperinsulinemia may cause left ventricular hypertrophy
Insulin resistance and left ventricular hypertrophy as parallel phenomena
Left ventricular hypertrophy as a causal factor for hypertension and insulin resistance
THE CLINICAL IMPORTANCE OF LEFT VENTRICULAR HYPERTROPHY
Electrophysiologic co-morbidity of left ventricular hypertrophy
Prognostic significance of echocardiographic and electrocardiographic left ventricular hypertrophy
STRENGTHS AND LIMITATIONS OF THE STUDY
CONCLUSIONS
FUTURE PERSPECTIVES
ACKNOWLEDGEMENTS
SUMMARY IN SWEDISH
REFERENCES
Author: Sundström, Johan
Source: Uppsala University Library
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