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Title: | Pulmonary hypertension during exercise underlies unexplained exertional dyspnoea in patients with Type 2 diabetes | Authors: | GOJEVIC, Tin VAN RYCKEGHEM, Lisa Jogani, Siddharth FREDERIX, Ines Bakelants , Elise Petit, Thibault Stroobants , Sarah DENDALE, Paul BITO, Virginie HERBOTS, Lieven HANSEN, Dominique VERWERFT, Jan |
Issue Date: | 2022 | Publisher: | OXFORD UNIV PRESS | Source: | European journal of preventive cardiology (Print), 30 (1), p. 37-45 | Abstract: | Aims To compare the cardiac function and pulmonary vascular function during exercise between dyspnoeic and non-dyspnoeic patients with Type 2 diabetes mellitus (T2DM). Methods and results Forty-seven T2DM patients with unexplained dyspnoea and 50 asymptomatic T2DM patients underwent exercise echocardiography combined with ergospirometry. Left ventricular (LV) function [stroke volume, cardiac output (CO), LV ejection fraction, systolic annular velocity (s ')], estimated LV filling pressures (E/e '), mean pulmonary arterial pressures (mPAPs) and mPAP/COslope were assessed at rest, low- and high-intensity exercise with colloid contrast. Groups had similar patient characteristics, glycemic control, stroke volume, CO, LV ejection fraction, and E/e ' (P > 0.05). The dyspnoeic group had significantly lower systolic LV reserve at peak exercise (s ') (P = 0.021) with a significant interaction effect (P < 0.001). The dyspnoeic group also had significantly higher mPAP and mPAP/CO at rest and exercise (P < 0.001) with significant interaction for mPAP (P < 0.009) and insignificant for mPAP/CO (P = 0.385). There was no significant difference in mPAP/COslope between groups (P = 0.706). However, about 61% of dyspnoeic vs. 30% of non-dyspnoeic group had mPAP/COslope > 3 (P = 0.009). The mPAP/COslope negatively predicted V?O-2peak in dyspneic group (beta = -1.86, 95% CI: -2.75, -0.98; multivariate model R-2:0.54). Conclusion Pulmonary hypertension and less LV systolic reserve detected by exercise echocardiography with colloid contrast underlie unexplained exertional dyspnoea and reduced exercise capacity in T2DM. | Notes: | Gojevic, T (corresponding author), Hasselt Univ, Fac Rehabil Sci, REVAL Rehabil Res Ctr, Agoralaan,Bldg A, B-3590 Diepenbeek, Belgium.; Gojevic, T (corresponding author), Hasselt Univ, Fac Med & Life Sci, BIOMED Biomed Res Ctr, B-3500 Diepenbeek, Belgium. tin.gojevic@uhasselt.be |
Keywords: | Diabetes;Heart;Echocardiography;Shortness of breath;Pulmonary arterial pressure | Document URI: | http://hdl.handle.net/1942/38102 | ISSN: | 2047-4873 | e-ISSN: | 2047-4881 | DOI: | 10.1093/eurjpc/zwac153 | ISI #: | 000838695100001 | Rights: | The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please email: journals.permissions@oup.com. | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2023 |
Appears in Collections: | Research publications |
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