1. Asymptomatic type 2 diabetes mellitus display a reduced myocardial deformation but adequate response during exercise.
- Author
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Van Ryckeghem L, Keytsman C, Verbaanderd E, Frederix I, Bakelants E, Petit T, Jogani S, Stroobants S, Dendale P, Bito V, Verwerft J, and Hansen D
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Belgium epidemiology, Cardiomyopathies epidemiology, Cardiomyopathies pathology, Cross-Sectional Studies, Diabetes Mellitus, Type 2 epidemiology, Diabetes Mellitus, Type 2 pathology, Female, Humans, Male, Middle Aged, Stroke Volume, Ventricular Dysfunction, Left epidemiology, Young Adult, Cardiomyopathies physiopathology, Diabetes Mellitus, Type 2 physiopathology, Exercise Tolerance physiology, Ventricular Dysfunction, Left pathology
- Abstract
Background and Purpose: The development of myocardial fibrosis is a major complication of Type 2 diabetes mellitus (T2DM), impairing myocardial deformation and, therefore, cardiac performance. It remains to be established whether abnormalities in longitudinal strain (LS) exaggerate or only occur in well-controlled T2DM, when exposed to exercise and, therefore, cardiac stress. We therefore studied left ventricular LS at rest and during exercise in T2DM patients vs. healthy controls., Methods and Results: Exercise echocardiography was applied with combined breath-by-breath gas exchange analyses in asymptomatic, well-controlled (HbA1c: 6.9 ± 0.7%) T2DM patients (n = 36) and healthy controls (HC, n = 23). Left ventricular LS was assessed at rest and at peak exercise. Peak oxygen uptake (V̇O
2peak ) and workload (Wpeak ) were similar between groups (p > 0.05). Diastolic (E, e's , E/e') and systolic function (left ventricular ejection fraction) were similar at rest and during exercise between groups (p > 0.05). LS (absolute values) was significantly lower at rest and during exercise in T2DM vs. HC (17.0 ± 2.9% vs. 19.8 ± 2% and 20.8 ± 4.0% vs. 23.3 ± 3.3%, respectively, p < 0.05). The response in myocardial deformation (the change in LS from rest up to peak exercise) was similar between groups (+ 3.8 ± 0.6% vs. + 3.6 ± 0.6%, in T2DM vs. HC, respectively, p > 0.05). Multiple regression revealed that HDL-cholesterol, fasted insulin levels and exercise tolerance accounted for 30.5% of the variance in response of myocardial deformation in the T2DM group (p = 0.002)., Conclusion: Myocardial deformation is reduced in well-controlled T2DM and despite adequate responses, such differences persist during exercise., Trial Registration: NCT03299790, initially released 09/12/2017.- Published
- 2021
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