Scope: Hypertension (HT) and insulin resistance (IR) often coexist, aggravating patient’s cardiovascular risk profile. Cardiac remodelling (CR) is a reliable bio-marker of target organ damages in both pathological conditions, and its severity would correlate with the degree of carbohydrate metabolism’s impairment. Aim: To determine whether HOMA IR indices could play a predictive role in appreciating the severity of LVremodeling.
Methods: 101 hypertensive patients (mean age 50.11 ± 0.79 yrs; 48.51% of men, SBP/DBP: 201.31± 7.41/106.25 54 mmHg) with CR and IR (HOMAIR >2.5) were enrolled for the study. Relative wall thickness (RWT >0.43) categorize geometry of LV remodelling. LVMI >95 g/m2 in women and >115 g/m2 in men identified LVH. TTE and HOMAIR testing were performed at baseline and after 6, 12- months of follow-up. Correlation analysis was performed using Pearson’s test. The correlation coefficient was considered weak at <0.3, medium-0.3-0.7 and strong> 0.7-1.0. Statistical signi-ficance was appreciated at a P-value <0.05 and highly significant at a P-value <0.001.
Results: At baseline, the group was comparable according to clinical, hemodynamic and TTE characte-ristics, p >0.05. A medium statistical correlation was found between LV concentric remodeling, eccentric LV hypertrophy (LVH) and HOMAIR 2.6-3.0 values (r=0.56, and r=0.62, respectively; p <0.001). With the increase in HOMAIR index >3.1, a strong statistical correlation was noted for both the CR patterns (r=0.80, and r=0.81, respectively; p <0.001). Concentric LVH correlated significantly with both the HOMAIR in-dex 2.6-3.0 (r=0.72; p <0.001), and values above >3.1 (r=0.72, and r=0.84, respectively; p <0.001).
Conclusions: Insulin resistance is associated with impaired left ventricular geometry, and this association appears to have a particularly strong relationship with higher HOMA-IR levels. The more advanced patterns of LV remodelling occurred, the stronger is the interde-pendence with higher HOMA-IR levels. Thus, the HO-MAIR values would have a predictive role in assessing the extent of pathological LV remodelling in hypertensive patients and associated insulin resistance.