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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 |
Issue Date: | 2021 | Publisher: | SPRINGER | Source: | European journal of applied physiology (Print), 121 (3), p. 929-940 | 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 ventricu-lar LS was assessed at rest and at peak exercise. Peak oxygen uptake (V̇ O 2peak) and workload (W peak) 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. | Keywords: | Type 2 diabetes mellitus;Stress echocardiography;Exercise tests;Left ventricular longitudinal strain | Document URI: | http://hdl.handle.net/1942/33099 | ISSN: | 1439-6319 | e-ISSN: | 1439-6327 | DOI: | 10.1007/s00421-020-04557-5 | ISI #: | WOS:000606170700003 | Rights: | Springer-Verlag GmbH Germany, part of Springer Nature 2021 | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2022 |
Appears in Collections: | Research publications |
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File | Description | Size | Format | |
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Auteursversie.pdf | Peer-reviewed author version | 1.25 MB | Adobe PDF | View/Open |
s00421-020-04557-5.pdf Restricted Access | Published version | 1.87 MB | Adobe PDF | View/Open Request a copy |
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