ABSTRACT
Left ventricular (LV) diastolic dysfunction is increasingly recognized as an important cause of heart failure, providing prognostic information that is incremental to systolic function. Symptomatic DD can occur in association to left ventricular (LV) systolic dysfunction or be a determinant of heart failure with preserved systolic function (ejection fraction >50%), which is responsible for 51% of the heart failure cases. We sought to examine the relationship between atrial volume indexed to body surface area (LAVi) and clinical and Doppler echocardiographic parameters in randomly selected participants. Methods: The Present study included 1021 subjects of both gender. Two-dimensional and color Doppler imaging were performed to screen for valvular stenosis or regurgitation. Diastolic function was graded as normal, abnormal relaxation (Grade I), pseudonormal (Grade II), and restrictive (Grade III). Results: Mean LAVi and the prevalence of LA enlargement increase with worsening diastolic function grade. Distribution of diastolic function and the associated mean LAVi. Atrial size, as measured by LAVi, increases progressively with increasing DD (r <0.20; p<0.01). The prevalence of LA enlargement also increases with increasing severity of DD. After controlling for age, gender, EF, and LAVi, diastolic function grade was associated with all-cause mortality. Adjusting for age, gender, EF, and diastolic function grade, LAVi was not associated with all-cause mortality. Conclusion: This study in Indian population suggests that DD contributes to left atrial remodeling and LAVI increase is an expression of DD severity. LAVI increase determinants in this sample with preserved or slightly reduced mean ejection fraction and no significant valvular heart disease are partly related to age, left ventricular hypertrophy, increased filling pressure and decreased LV systolic function
ABSTRACT
Background: Haemoglobin A1c (HbA1c) is a glycated form of haemoglobin reflects average plasma glucose over the previous 8 to 12 weeks. HbA1c can be affected by multiple non-glycaemic parameters. Iron deficiency anaemia (IDA) is one among them which is the most common type of anaemia in India. However, reports on the effects of iron deficiency anaemia on HbA1c levels are inconsistent. Hence we conducted a study to find out the influence of iron deficiency anaemia over HbA1c levels. Methods: 120 patients confirmed to have iron deficiency anaemia were enrolled in this study. HbA1c levels were measured at baseline and 3 months after treatment, and these values were compared with those in the control population.Results: The mean baseline HbA1c level in anaemic patients (4.62%) was significantly lower than that in the control group (5.45%, P<0.001). A significant increase was observed in the patients HbA1c levels at 3 months after treatment (5.82%, P<0.001). There was a significant correlation observed between haemoglobin and HbA1c level (Coefficient of correlation=0.26, P<0.01) in the study group before correction.Conclusions: In contrast to the observations of previous studies, ours showed that HbA1c levels increased with treatment of iron deficiency anaemia. This could be attributable to nutritional deficiency, racial-ethnic variations and/or certain unknown variables. Further studies are warranted.