| Cardiac dysfunction during exercise in uncomplicated type 2 diabetes. | |
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MedLine Citation:
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PMID: 19346991 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: Type 2 diabetes mellitus (T2DM) has been associated with reduced peak exercise capacity (VO(2peak)). The causes of this impairment are not clearly established, but evidence suggests that abnormalities in cardiac function play a significant role. We hypothesized that exercise would be associated with impaired cardiac function and hemodynamics in recently diagnosed T2DM, even in the absence of clinically evident cardiovascular complications. METHODS: After baseline normal echocardiography screening, 10 premenopausal women with uncomplicated T2DM (average duration of diagnosed T2DM, 3.6 yr) and 10 healthy nondiabetic women of similar age, weight, and activity levels performed a peak cardiopulmonary exercise test while instrumented with an indwelling pulmonary artery catheter for assessing cardiac function. On separate days, technetium-99m sestamibi (cardolite) imaging was performed to assess myocardial perfusion at rest and peak exercise in seven T2DM and seven control patients. RESULTS: Resting measures of cardiac hemodynamics were similar in T2DM and control subjects. Absolute VO(2peak) (mL x min(-1)) and peak cardiac output (L x min(-1)) tended to be lower in T2DM than in control subjects but did not reach statistical significance. However, pulmonary capillary wedge pressure (PCWP) rose significantly more during exercise in T2DM than in controls (148% vs 109% increase at peak exercise, P < 0.01). Normalized myocardial perfusion index was lower in persons with diabetes than in controls (11.0 +/- 3.5 x e(-9) vs 17.5 +/- 8.1 x e(-9), respectively, P < 0.05) and inversely related to peak exercise PCWP (R = -0.56, P < 0.05). CONCLUSIONS: Cardiac hemodynamics during graded exercise are altered in women with recently diagnosed T2DM as demonstrated by the disproportionate increase in PCWP at peak exercise compared with controls subjects. Cardiac abnormalities observed are potentially early signs of subclinical cardiac dysfunction associated with T2DM, which may precede the more greatly impaired cardiac function at rest and with exercise observed in longer established T2DM. |
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Authors:
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Judith G Regensteiner; Timothy A Bauer; Jane E B Reusch; Robert A Quaife; Marcus Y Chen; Susan C Smith; Tyler M Miller; Bertron M Groves; Eugene E Wolfel |
Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S. |
Journal Detail:
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Title: Medicine and science in sports and exercise Volume: 41 ISSN: 1530-0315 ISO Abbreviation: Med Sci Sports Exerc Publication Date: 2009 May |
Date Detail:
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Created Date: 2009-06-10 Completed Date: 2009-09-08 Revised Date: 2011-09-26 |
Medline Journal Info:
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Nlm Unique ID: 8005433 Medline TA: Med Sci Sports Exerc Country: United States |
Other Details:
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Languages: eng Pagination: 977-84 Citation Subset: IM; S |
Affiliation:
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Division of General Internal Medicine, Department of Medicine, School of Medicine, University of Colorado Denver, Aurora, CO 80045, USA. judy.regensteiner@uchsc.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Cardiac Output, Low / physiopathology* Diabetes Mellitus, Type 2* Exercise / physiology* Female Heart Function Tests Hemodynamics / physiology Humans Middle Aged Oxygen Consumption / physiology* Perfusion Pulmonary Wedge Pressure / physiology |
| Grant Support | |
ID/Acronym/Agency:
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M01 RR000051-43/RR/NCRR NIH HHS; M01-RR00051/RR/NCRR NIH HHS; R55 DK053776-01/DK/NIDDK NIH HHS; R55 DK53776/DK/NIDDK NIH HHS |
| Comments/Corrections | |
Comment In:
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Med Sci Sports Exerc. 2009 Oct;41(10):1972-3; author reply 1974
[PMID:
21606907
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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