Imperial College London


Faculty of MedicineNational Heart & Lung Institute

Professor of Cardiology



+44 (0)20 7594 3381d.francis Website




Miss Juliet Holmes +44 (0)20 7594 5735




Block B Hammersmith HospitalHammersmith Campus






BibTex format

author = {Park, CM and Tillin, T and March, K and Ghosh, AK and Jones, S and Wright, A and Heasman, J and Francis, D and Sattar, N and Mayet, J and Chaturvedi, N and Hughes, AD},
doi = {10.2337/dc13-1864},
journal = {Diabetes Care},
pages = {1124--1131},
title = {Hyperglycemia Has a Greater Impact on Left Ventricle Function in South Asians Than in Europeans},
url = {},
volume = {37},
year = {2014}

RIS format (EndNote, RefMan)

AB - OBJECTIVE Diabetes is associated with left ventricular (LV) diastolic and systolic dysfunction. South Asians may be at particular risk of developing LV dysfunction owing to a high prevalence of diabetes. We investigated the role of diabetes and hyperglycemia in LV dysfunction in a community-based cohort of older South Asians and white Europeans.RESEARCH DESIGN AND METHODS Conventional and Doppler echocardiography was performed in 999 participants (542 Europeans and 457 South Asians aged 58–86 years) in a population-based study. Anthropometry, fasting bloods, coronary artery calcification scoring, blood pressure, and renal function were measured.RESULTS Diabetes and hyperglycemia across the spectrum of HbA1c had a greater adverse effect on LV function in South Asians than Europeans (N-terminal-probrain natriuretic peptide β ± SE 0.09 ± 0.04, P = 0.01, vs. −0.04 ± 0.05, P = 0.4, P for HbA1c/ethnicity interaction 0.02), diastolic function (E/e′ 0.69 ± 0.12, P < 0.0001, vs. 0.09 ± 0.2, P = 0.6, P for interaction 0.005), and systolic function (s′ −0.11 ± 0.06, P = 0.04, vs. 0.14 ± 0.09, P = 0.1, P for interaction 0.2). Multivariable adjustment for hypertension, microvascular disease, LV mass, coronary disease, and dyslipidemia only partially accounted for the ethnic differences. Adverse LV function in diabetic South Asians could not be accounted for by poorer glycemic control or longer diabetes duration.CONCLUSIONS Diabetes and hyperglycemia have a greater adverse effect on LV function in South Asians than Europeans, incompletely explained by adverse risk factors. South Asians may require earlier and more aggressive treatment of their cardiometabolic risk factors to reduce risks of LV dysfunction.
AU - Park,CM
AU - Tillin,T
AU - March,K
AU - Ghosh,AK
AU - Jones,S
AU - Wright,A
AU - Heasman,J
AU - Francis,D
AU - Sattar,N
AU - Mayet,J
AU - Chaturvedi,N
AU - Hughes,AD
DO - 10.2337/dc13-1864
EP - 1131
PY - 2014///
SN - 1935-5548
SP - 1124
TI - Hyperglycemia Has a Greater Impact on Left Ventricle Function in South Asians Than in Europeans
T2 - Diabetes Care
UR -
UR -
VL - 37
ER -