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- Title
Asymptomatic type 2 diabetes mellitus display a reduced myocardial deformation but adequate response during exercise.
- Authors
Van Ryckeghem, Lisa; Keytsman, Charly; Verbaanderd, Elvire; Frederix, Ines; Bakelants, Elise; Petit, Thibault; Jogani, Siddharth; Stroobants, Sarah; Dendale, Paul; Bito, Virginie; Verwerft, Jan; Hansen, Dominique
- Abstract
<bold>Background and Purpose: </bold>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.<bold>Methods and Results: </bold>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 (V̇O2peak) 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).<bold>Conclusion: </bold>Myocardial deformation is reduced in well-controlled T2DM and despite adequate responses, such differences persist during exercise.<bold>Trial Registration: </bold>NCT03299790, initially released 09/12/2017.
- Publication
European Journal of Applied Physiology, 2021, Vol 121, Issue 3, p929
- ISSN
1439-6319
- Publication type
journal article
- DOI
10.1007/s00421-020-04557-5