Document Detail

Cardiac and plasma catecholamine responses to exercise in patients with type 2 diabetes: prognostic implications for cardiac-cerebrovascular events.
MedLine Citation:
PMID:  10910370     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Patients with diabetes mellitus have an altered exercise plasma catecholamine response, which may be related to the abnormal sympathoadrenal function and autonomic neuropathy. Presence of autonomic neuropathy is associated with poor prognosis, but relationship between exercise plasma catecholamine and prognosis has not been investigated. This study determined if altered plasma catecholamine response to exercise was associated with cardiac-cerebrovascular events. METHODS: Forty patients with type 2 diabetes without apparent macrovascular complications and 30 control subjects performed treadmill exercise with serial measurements of plasma norepinephrine and epinephrine. Clinical, exercise, and catecholaminergic variables considered relevant to the cardiac-cerebrovascular events were examined by Cox regression model. Analysis of 24-hour heart rate variability was performed in a subgroup of patients. RESULTS: During 7.2 years, 8 patients, but no control subjects, had events (3 myocardial and 5 cerebral infarctions). Compared with Event(-) patients, Event(+) patients had: (1) orthostatic hypotension; (2) lower peak exercise heart rate; (3) lower plasma norepinephrine immediately after exercise; and (4) lower plasma epinephrine at peak exercise. High frequency components in heart rate variability analysis were diminished in Event(+) patients. Multivariate analysis showed that peak heart rate (P = 0.04) and plasma epinephrine at peak exercise (P = 0.03) were independent predictors of subsequent events. CONCLUSIONS: These data suggest that chronotropic incompetence and lower plasma epinephrine response to exercise are associated with high risk of cardiac-cerebrovascular events in patients with type 2 diabetes.
A Endo; T Kinugawa; K Ogino; M Kato; T Hamada; S Osaki; O Igawa; I Hisatome
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of the medical sciences     Volume:  320     ISSN:  0002-9629     ISO Abbreviation:  Am. J. Med. Sci.     Publication Date:  2000 Jul 
Date Detail:
Created Date:  2000-08-03     Completed Date:  2000-08-03     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370506     Medline TA:  Am J Med Sci     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  24-30     Citation Subset:  AIM; IM    
The First Department of Internal Medicine, Faculty of Medicine, Tottori University, Yonago, Japan.
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MeSH Terms
Catecholamines / secretion*
Coronary Disease / etiology*
Diabetes Mellitus, Type 2 / complications*,  metabolism
Heart Rate
Middle Aged
Multivariate Analysis
Stroke / etiology*
Reg. No./Substance:

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