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P115. Diastolic dysfunction and its relation with insulin resistance in patients with inflammatory bowel disease

G. Adali1, E. Yorulmaz1, H. Yorulmaz2, U. Akkose3, H. Ciftci3, A. Kayabilge4, I. Tuncer1

1S.B. Istanbul Goztepe Eah Gastroenterology, Istanbul, Turkey; 2Halic University, Istanbul, Turkey; 3S.B. Istanbul Goztepe Eah Cardiology, Istanbul, Turkey; 4Istanbul Medical Faculty Cardiology, Istanbul, Turkey

Aim: Crohn's disease (CD) and ulcerative colitis (UC) are chronic inflammatory bowel diseases (IBD) of unknown origin. These conditions are characterized by focal or diffuse inflammation of the alimentary tract and they can also affect other organs. Cardiac involvement in IBD is considered rare and the prevalence of left ventricular diastolic dysfunction in inactive disease is unknown. The aim of the present study is to assess left ventricular diastolic dysfunction in inactive IBD patients and to evaluate its possible correlation with duration, localization and metabolic parameters.

Materials and Methods: A group of 112 inactive IBD patients (72 with UC, 44 with CD) and a control group of 33 healthy subjects were investigated for diastolic dysfunction using transthoracic echocardiography as defined by E/A ratio <1 and E-wave deceleration time >220 ms, and measured for blood pressure levels, body mass index, waist circumference, total cholesterol, LDL-cholesterol, triglycerides, glucose, insulin and homeostasis model of assessment index for insulin resistance (HOMA-IR). None of the patients had diabetes mellitus, essential hypertension, ischemic heart disease hypothyroidism, amyloidosis, chronic obstructive pulmonary disease, ankylosing spondylitis and chronic renal failure.

Results: Patients with UC (n = 26, 36.1%) had a higher prevalence of diastolic dysfunction compared to those with CD (n = 2, 5%) and healthy subjects (n = 4, 12.1%) (p < 0.001). Body mass index, waist circumference, blood pressure levels, LDL-cholesterol, insulin and HOMA-IR were higher in patients with UC than in those with CD and healthy subjects (p < 0.05) and were associated with diastolic dysfunction in patients with UC at univariate analysis. Diastolic dysfunction was not associated with duration or localization in patients with UC.

Conclusions: Patients with UC had a higher prevalence of diastolic dysfunction and insulin resistance than those with CD and healthy subjects, suggesting a concomitant increase of metabolic and cardiac risks in this condition.