Correlates and Severity of Left Ventricular Hypertrophy in Type 2 Diabetes Patients in an Afro-Arab-cross Ethnic Community

Abstract

Background: The cardiovascular (CV) diseases, including left ventricular hypertrophy (LVH) are major causes of morbidity and mortality in T2DM. The LVH is associated with ventricular arrhythmias, ischemic heart disease (IHD), heart failure and sudden death. Although the LVH is frequent in T2DM, screening for this disorder is frequently done. Material and Methods: In this study, 120 Sudanese T2DM patients were recruited, (70 with and 50 without LVH) from four cardiac centers in Khartoum, the latter is inhabited by most of the Sudanese Afro-Arab ethnic groups. Clinical data were obtained from almost all patients together with measurement of glycemic and renal parameters. Echocardiography was performed for each patient, the left ventricle geometry components including the relative wall thickness (RWT) were estimated and the left ventricle mass index (LVMI) was calculated. Results: The commonest LVH type was eccentric (65.7%), and grade was severe (37.1%), and both were strongly associated, p<0.001, while the frequency of the mild LVH was 28.6%. Out of 10 tested variables only HhA1c (p<0.001), urea (p=0.039) and creatinine (p=0.043) were significantly associated with LVH, while the sex, age, T2DM duration, smoking, obesity, random and fasting blood glucose were not. Moreover, the LVMI was positively correlated with HbA1c (CC0.188, p<0.039), and negatively with RWT (CC-0.495, p<0.000). Finally, significantly higher number of patients with IHD (p=0.038) and cerebral complications (p=0.014) had LVH. Conclusion: In this unique setting of interethnic cross, the results suggest that more genetic than environmental factors could be involved in diabetic LVH development.