Impact of left ventricular diastolic dysfunction on maximal treadmill performance in normotensive subjects with well-controlled type 2 diabetes mellitus

Poirier, Paul; Garneau, Caroline; Bogaty, Peter; Nadeau, André; Marois, Louise; Brochu, Claudette; Gingras, Cécile; Fortin, Claudette; Jobin, Jean; Dumesnil, Jean-G

doi:10.1016/s0002-9149(99)00774-2

Cited by 135 publications

(107 citation statements)

References 26 publications

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“…Among the indices of LV function only maximal -dP/dt decreased in OLETF rats compared to LETO rats, suggesting impaired myocardial relaxation [27]. Relaxation abnormality in the diabetic heart has been found in clinical studies as well as experimental investigations [28,29]. Another study [30] recently reported that an increase of interstitial collagen and diastolic filling abnormalities appeared in the pre-diabetic stage in OLETF rats.…”

Section: Discussionmentioning

confidence: 95%

Alteration in haemodynamics and pathological changes in the cardiovascular system during the development of Type 2 diabetes mellitus in OLETF rats

et al. 2003

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Aims/hypothesis. The process of cardiovascular complications in Type 2 diabetes mellitus (DM) is unclear. We investigated pathophysiological changes of the heart and vessels in the Otsuka Long-Evans Tokushima Fatty (OLETF) rat Type 2 DM model during a long time period. Methods. Echocardiography was carried out at 22 and 62 weeks of age of OLETF (n=10, each) and agematched Long-Evans Tokushima Otsuka (LETO) rats (n=10, each) as a reference. Haemodynamic measurements and histological examinations of the heart and the coronary and aortic vascular walls were done. Results. The left ventricular (LV) maximal -dP/dt was reduced in OLETF rats at 62 weeks (-1085±35 mmHg/s) less than that at 22 weeks (-1892±396 mmHg/sec, p<0.05) and in LETO rats at 62 weeks (-1306±200 mmHg/sec,p<0.05). Wall thickening of intramyocardial coronary arteries, capillary tortuosity and thickening of basement membrane were evident in OLETF rats at 62 weeks. Intimal and medial wall thickening of the aorta were prominent in OLETF rats at 62 weeks (15±2.2 and 90±6.6 µm, in LETO rats at 62 weeks, 2±0.4 and 65±5.2 µm,p <0.05, and in OLETF rats at 22 weeks, 7±4.6 and 71±6.0 µm, p<0.05, respectively). Conclusions/interpretation. In the Type 2 DM model, angiopathy, especially in coronary arteries including small vessels, as well as a LV relaxation abnormality, are induced in a late stage of DM. These are considered to be important complications in Type 2 DM.

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Section: Discussionmentioning

confidence: 95%

Alteration in haemodynamics and pathological changes in the cardiovascular system during the development of Type 2 diabetes mellitus in OLETF rats

et al. 2003

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“…Compared to systolic function, diastolic function has received little attention in humans suffering from severe aortic regurgitation 52,53 . However, it has been suggested that abnormalities in diastolic function may influence the symptomatic status as well as the prognosis of subjects with severe aortic regurgitation as in other cardiac diseases such as myocardial infarction, congestive heart failure, diabetes and hypertension [54][55][56][57][58][59] . The occurrence of left ventricular filling abnormalities in our animals therefore deserves further attention and investigation.…”

Section: Discussionmentioning

confidence: 99%

Left ventricular response to sustained volume overload from chronic aortic valve regurgitation in rats

Plante

Couët

Gaudreau

et al. 2003

Journal of Cardiac Failure

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“…In subjects without evidence of clinical cardiovascular disease at baseline, the presence of subclinical disease is associated with a significantly increased risk of coronary heart disease, with the increased risk of total mortality being 2.9 for men and 1.7 for women [1]. Moreover, in uncomplicated well-controlled type 2 diabetes, LV dysfunction detected by echocardiography has been associated with impaired functional capacity observed in these patients [2]. A follow-up study over 6.4 years demonstrated that diabetic subjects had a higher prevalence of clinical and subclinical cardiovascular disease at baseline, and the presence of subclinical cardiovascular disease and diabetes was associated with significantly increased adjusted relative risk of death, relative risk of incident coronary heart disease, and incident myocardial infarction [3].…”

Section: Introductionmentioning

confidence: 99%

Determinants of subclinical diabetic heart disease

et al. 2005

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Aims/hypothesis: Subclinical left ventricular (LV) dysfunction has been shown by tissue Doppler and strain imaging in diabetic patients in the absence of coronary disease or LV hypertrophy, but the prevalence and aetiology of this finding remain unclear. This study sought to identify the prevalence and the determinants of subclinical diabetic heart disease. Methods: A group of 219 unselected patients with type 2 diabetes without known cardiac disease underwent resting and stress echocardiography. After exclusion of coronary artery disease or LV hypertrophy, the remaining 120 patients (age 57±10 years, 73 male) were studied with tissue Doppler imaging. Peak systolic strain of each wall and systolic (Sm) and diastolic (Em) velocity of each basal segment were measured from the three apical views and averaged for each patient. Significant subclinical LV dysfunction was identified according to Sm and Em normal ranges adjusted by age and sex. Strain and Em were correlated with clinical, therapeutic, echocardiographic and biochemical variables, and significant independent associations were sought using a multiple linear regression model. Results: Significant subclinical LV dysfunction was present in 27% diabetic patients. Myocardial systolic dysfunction by peak strain was independently associated with glycosylated haemoglobin level (p<0.001) and lack of angiotensin-converting enzyme inhibitor treatment (p=0.003). Myocardial diastolic function (Em) was independently predicted by age (p=0.013), hypertension (p=0.001), insulin (p=0.008) and metformin (p=0.01) treatment. Conclusions/interpretation: In patients with diabetes mellitus, subclinical LV dysfunction is common and associated with poor diabetic control, advancing age, hypertension and metformin treatment; ACE inhibitor and insulin therapies appear to be protective.

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Impact of left ventricular diastolic dysfunction on maximal treadmill performance in normotensive subjects with well-controlled type 2 diabetes mellitus

Cited by 135 publications

References 26 publications

Alteration in haemodynamics and pathological changes in the cardiovascular system during the development of Type 2 diabetes mellitus in OLETF rats

Alteration in haemodynamics and pathological changes in the cardiovascular system during the development of Type 2 diabetes mellitus in OLETF rats

Left ventricular response to sustained volume overload from chronic aortic valve regurgitation in rats

Determinants of subclinical diabetic heart disease

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