Echo Doppler diastolic function and exercise tolerance

Genovesi-Ebert, A; Marabotti, C; Palombo, Carlo; Giaconi, S; Rossi, Giuseppe; Ghione, S

doi:10.1016/0167-5273(94)90092-2

Cited by 30 publications

(26 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The association in this study between LV diastolic dysfunction and exercise performance in type 2 diabetes is consistent with results from previous studies in patients without (21) and with (2) type 2 diabetes. The lack of correlation between exercise capacity and LV systolic function in this study also confirms previous studies showing a poor correlation of exercise capacity with indexes of LV systolic function in patients with dilated cardiomyopathy (22) and hypertensive heart disease (23).…”

Section: Exercise Capacity and LV Functionsupporting

confidence: 82%

Determinants of Exercise Capacity in Patients With Type 2 Diabetes

et al. 2005

View full text Add to dashboard Cite

OBJECTIVE -Type 2 diabetes is associated with reduced exercise capacity, but the cause of this association is unclear. We sought the associations of impaired exercise capacity in type 2 diabetes. RESEARCH DESIGN AND METHODS -Subclinical left ventricular (LV) dysfunctionwas sought from myocardial strain rate and the basal segmental diastolic velocity (Em) of each wall in 170 patients with type 2 diabetes (aged 56 Ϯ 10 years, 91 men), good quality echocardiographic images, and negative exercise echocardiograms. The same measurements were made in 56 control subjects (aged 53 Ϯ 10 years, 29 men). Exercise capacity was calculated in metabolic equivalents, and heart rate recovery (HRR) was measured as the heart rate difference between peak and 1 min after exercise. In subjects with type 2 diabetes, exercise capacity was correlated with clinical, therapeutic, biochemical, and echocardiographic variables, and significant independent associations were sought using a multiple linear regression model. RESULTS -Exercise capacity, strain rate, Em, and HRR were significantly reduced in type 2 diabetes. Exercise capacity was associated with age (r ϭ Ϫ0.37, P Ͻ 0.001), male sex (r ϭ 0.26, P ϭ 0.001), BMI (r ϭ Ϫ0.19, P ϭ 0.012), HbA 1c (A1C; r ϭ Ϫ0.22, P ϭ 0.009), Em (r ϭ 0.43, P Ͻ 0.001), HRR (r ϭ 0.42, P Ͻ 0.001), diabetes duration (r ϭ Ϫ0.18, P ϭ 0.021), and hypertension history (r ϭ Ϫ0.28, P Ͻ 0.001). Age (P Ͻ 0.001), male sex (P ϭ 0.007), BMI (P ϭ 0.001), Em (P ϭ 0.032), HRR (P ϭ 0.013), and A1C (P ϭ 0.0007) were independent predictors of exercise capacity.CONCLUSIONS -Reduced exercise capacity in patients with type 2 diabetes is associated with diabetes control, subclinical LV dysfunction, and impaired HRR. Diabetes Care 28:1643-1648, 2005C linical and observational studies have shown that exercise capacity is a strong predictor of cardiovascular and overall mortality (1). Patients with type 2 diabetes often complain of fatigue and reduced exercise capacity. Although these symptoms may be related to other disease conditions, such as hypertensive left ventricular (LV) hypertrophy or coronary artery disease, the presence of diabetes may independently contribute to the impaired exercise capacity (2).The causes of reduced exercise capacity in type 2 diabetes are unknown. Overt LV diastolic dysfunction, evidenced by abnormal transmitral flow, has been associated with impaired functional capacity in uncomplicated well-controlled type 2 diabetes (2). However, primary myocardial disease may be present in many patients with type 2 diabetes, without overt systolic or diastolic dysfunction, independent of LV hypertrophy and coronary artery disease (3). Cardiac autonomic dysfunction may play an important role in the development of diabetic heart disease (3). Reduced heart rate recovery (HRR) immediately after exercise is an important indicator of cardiac autonomic dysfunction and contributes to cardiovascular morbidity and mortality in other diseases (4,5). In this study, we sought the extent to which diabetes control, impaired HRR, a...

show abstract

Section: Exercise Capacity and LV Functionsupporting

confidence: 82%

Determinants of Exercise Capacity in Patients With Type 2 Diabetes

et al. 2005

View full text Add to dashboard Cite

show abstract

“…In our study, VO 2 peak was inversely correlated with peak A, even after age adjustment [31]. E/E’, as a noninvasive estimation of LV filling pressure [15, 25], was also negatively correlated with VO 2 peak [32].…”

Section: Discussionmentioning

confidence: 99%

Impaired Exercise Capacity in Diabetic Patients after Coronary Bypass Surgery: Effects of Diastolic and Endothelial Function

Hsu

Wang

et al. 2007

Cardiology

View full text Add to dashboard Cite

Objectives: The aims of this study were to clarify the influence of cardiac diastolic and peripheral vascular function on the exercise capacity of patients with coronary bypass surgery (CABG) and diabetes mellitus (DM) by tissue Doppler imaging (TDI) and flow-mediated vasodilatation (FMD), and to investigate interrelations between exercise capacity and LV diastolic function, endothelial function and biochemical parameters. Methods: We analyzed the exercise capacity, TDI at the mitral annulus and FMD in 51 uncomplicated first-time CABG survivors (23 DM) at an average interval of 21.6 ± 12.2 months after surgery. Results: Diabetics had lower E’, A’, VO₂peak, (a-v)O₂ difference, and higher E/E’ ratios (p < 0.05) than non-DM patients, but not FMD (p = 0.17). The A and E/E’ ratios correlated negatively with VO₂peak after age adjustment (r = –0.336, p = 0.024). In addition, HbA_1c, and triglyceride also correlated negatively with VO₂peak (r = –0.377, –0.307, respectively, p < 0.05). Conclusions: Diabetics after CABG had more advanced diastolic dysfunction and oxygen extraction impairment than non-DM. It suggests these factors could contribute to lower exercise capacity, risk of developing heart failure despite preserved systolic function and poorer long-term survival of diabetic patients after CABG.

show abstract

“…Recently, several studies have shown correlations between resting LVDF and exercise tolerance, [3][4][5] though the relationships were relatively weak or moderate. We hypothesized that LVDF during exercise has a strong influence on exercise tolerance, and are interested in the relationship between changes in LVDF during exercise and exercise tolerance.…”

mentioning

confidence: 99%

Effect of Changes in Left Ventricular Diastolic Function During Exercise on Exercise Tolerance Assessed by Exercise-Stress Tissue Doppler Echocardiography

et al. 2009

View full text Add to dashboard Cite

SummaryCardiac function during exercise is assumed to be important in determining exercise tolerance. The aims of this study were to evaluate changes in left ventricular diastolic function (LVDF) during exercise and its effect on exercise tolerance assessed by a noninvasive method, exercise-stress tissue Doppler echocardiography. Twenty-six men with sinus rhythm (controls, hypertension, and cardiomyopathy) underwent cardiopulmonary exercise testing. To assess LVDF during exercise, exercise-stress Doppler echocardiography was performed with a constant workload at rest, and at 50%, 100%, and 120% of anaerobic threshold (AT). Doppler variables related to LVDF increased significantly as the workload increased (P < 0.05). Resting E' correlated significantly with AT (r = 0.424, P = 0.0308) and peak V 4 O 2 (r = 0.471, P = 0.0152). However, the difference in E' between rest and 120% AT (∆E') was closely correlated with AT (r = 0.744, P < 0.0001) and peak V 4 O 2 (r = 0.748, P < 0.0001). Moreover, ∆E' was correlated independently with AT (P = 0.0321) and peak V 1) However, the correlation between objective measurements of exercise tolerance and systolic left ventricular function is poor.2) It is clear that left ventricular diastolic function (LVDF) is an important determinant of exercise tolerance in normal individuals and in patients with various cardiac diseases. Recently, several studies have shown correlationsFrom the

show abstract

Echo Doppler diastolic function and exercise tolerance

Cited by 30 publications

References 21 publications

Determinants of Exercise Capacity in Patients With Type 2 Diabetes

Determinants of Exercise Capacity in Patients With Type 2 Diabetes

Impaired Exercise Capacity in Diabetic Patients after Coronary Bypass Surgery: Effects of Diastolic and Endothelial Function

Effect of Changes in Left Ventricular Diastolic Function During Exercise on Exercise Tolerance Assessed by Exercise-Stress Tissue Doppler Echocardiography

Contact Info

Product

Resources

About