Type 2 Diabetes Mellitus, Glycated Hemoglobin Levels, and Cardiopulmonary Exercise Capacity in Patients With Ischemic Heart Disease

Uribe-Heredia, G; Arroyo-Espliguero, Ramón; Viana-Llamas, María C; Piccone-Saponara, L G; Alvaro-Fernandez, H; García-Magallón, B; Torán-Martínez, C; Silva-Obregón, J. Alberto; Alonso, José Luís Izquierdo

doi:10.1097/hcr.0000000000000451

Cited by 7 publications

(5 citation statements)

References 24 publications

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“…Appropriate to our study Yu-Mi Lee, et al (26) also found that educational interventions can increase heart symptoms management, self-care, psychological condition, and the QOL in the intervention group compared with the control group (16,17,19). Moreover, a similar study demonstrated that health educational intervention is very useful in health system divisions where fund and information penetration are always an issue faced by typical health education methods.…”

Section: Discussionsupporting

confidence: 66%

WITHDRAWN: The Effect of Mobile Health Intervention on Adherence to a Healthy Lifestyle in Patients with Cardiac Syndrome X (CSX)

Malekzadeh¹,

Chong²,

Li³

et al. 2021

Preprint

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Background: Cardiac syndrome X (CSX) is regarded as a form of ischemic heart disease with functional coronary microvascular abnormalities. This abnormal functioning of coronary microvasculature, often associated with endothelial dysfunction, results in a reduced coronary blood flow reserve. The incidence of CSX in patients undergoing invasive diagnostics for coronary heart disease was approximately 20–30%. Moreover, about 60–70% of CSX patients are female. The CSX symptoms are often debilitating and sufferers have a poor quality of life, with costly demand for healthcare services. METHODS The quasi-experimental survey was conducted in a teaching hospital. In this study, 100 Iranian outpatients who were referred to the heart clinic were recruited by randomized sampling. CSX patients were asked to fill out the demographic characteristics form and questionnaires in pre-test then after the period of intervention has been performed the post-test. Results: The independent t-test for continuous variable and chi - square test for categorical variables were used. There was no significant difference between two groups for all demographic of intervention and control groups, and RM-Manova was done for main research variables. The result revealed that score of knowledge on CSX risk factors was significantly higher in the experimental group (mean = 20.96) & (SD = 1.77), compared with the control group (mean = 16.32) & (SD = 3.12). Conclusion The mobile health messaging intervention significantly is useful for CSX Patients. The educational programs and Lifestyle modification represent a highly effective and low-cost intervention in order to improve the adherence to a healthy lifestyle among cardiac patients.

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Section: Discussionsupporting

confidence: 66%

WITHDRAWN: The Effect of Mobile Health Intervention on Adherence to a Healthy Lifestyle in Patients with Cardiac Syndrome X (CSX)

Malekzadeh¹,

Chong²,

Li³

et al. 2021

Preprint

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“…In our study, cardiopulmonary fitness and all the major parameters influencing VO 2peak —i.e., cardiac output, peripheral extraction, ventilation—were unaffected by either treatment, further sustaining the observations of a neutral effect of either drug on cardiopulmonary capacity in this population. The amelioration of glycaemic control is known to improve VO 2peak in T2D with established cardiac disease [ 34 , 35 ] and can justify the positive results of the non-controlled, non-randomized trials that were not confirmed when active controls were used, as it is in the present study. Interestingly, the subjects with HFrEF and concomitant therapy with loop diuretics showed a greater improvement in cardiorespiratory fitness when receiving empagliflozin [ 32 ] and this implies a synergism between the two diuretics in volume regulation as elegantly shown by Griffin et al [ 36 ].…”

Section: Discussionmentioning

confidence: 73%

Effect of empagliflozin on left ventricular contractility and peak oxygen uptake in subjects with type 2 diabetes without heart disease: results of the EMPA-HEART trial

Nesti

Pugliese

Sciuto

et al. 2022

Cardiovasc Diabetol

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Background The mechanism through which sodium-glucose cotransporter 2 inhibitors (SGLT2i) prevent the incidence of heart failure and/or affect cardiac structure and function remains unclear. Methods The EMPA-HEART trial is aimed at verifying whether empagliflozin improves myocardial contractility (left ventricle global longitudinal strain, LV-GLS) and/or cardiopulmonary fitness (peak oxygen uptake, VO2peak) in subjects with type 2 diabetes (T2D) without heart disease. Patients with T2D, normal LV systolic function (2D-Echo EF > 50%), and no heart disease were randomized to either empagliflozin 10 mg or sitagliptin 100 mg for 6 months and underwent repeated cardiopulmonary exercise tests with echocardiography and determination of plasma biomarkers. Results Forty-four patients completed the study, 22 per arm. Despite comparable glycaemic control, modest reductions in body weight (− 1.6; [− 2.7/− 0.5] kg, p = 0.03) and plasma uric acid (− 1.5; [− 2.3/− 0.6], p = 0.002), as well as an increase in haemoglobin (+ 0.7; [+ 0.2/+ 1.1] g/dL, p = 0.0003) were evident with empagliflozin. No difference was detectable in either LV-GLS at 1 month (empagliflozin vs sitagliptin: + 0.44; [− 0.10/+ 0.98]%, p = 0.11) and 6 months of therapy (+ 0.53; [− 0.56/+ 1.62]%), or in VO2peak (+ 0.43; [− 1.4/+ 2.3] mL/min/kg, p = 0.65). With empagliflozin, the subgroup with baseline LV-GLS below the median experienced a greater increase (time*drug p < 0.05) in LV-GLS at 1 month (+ 1.22; [+ 0.31/+ 2.13]%) and 6 months (+ 2.05; [+ 1.14/+ 2.96]%), while sitagliptin induced a modest improvement in LV-GLS only at 6 months (+ 0.92; [+ 0.21/+ 0.62]%). Conclusions Empagliflozin has neutral impact on both LV-GLS and exercise tolerance in subjects with T2D and normal left ventricular function. However, in patients with subclinical dysfunction (LV-GLS < 16.5%) it produces a rapid and sustained amelioration of LV contractility. Trial registration EUDRACT Code 2016-002225-10

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“…Type 2 diabetes (T2D) has been associated with limitation in physical performance in individuals with or without atherosclerotic cardiovascular diseases (ASCVD) (1)(2)(3)(4). These impairments in physical performance, measured as submaximal or maximal exercise capacity, manifest even with adequate glycemic control and in the absence of overt signs or symptoms of established ASCVD (1,(4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

Physical performance and glycemic control under SGLT-2-inhibitors in patients with type 2 diabetes and established atherosclerotic cardiovascular diseases or high cardiovascular risk (PUSH): Design of a 4-week prospective observational study

Frundi

Kettig

Popp

et al. 2022

Front. Cardiovasc. Med.

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BackgroundType 2 diabetes (T2D) is associated with limitation in physical performance. Results from animal studies report enhancement of physical performance in T2D rodents treated with sodium glucose cotransporter 2 inhibitors (SGLT2is). However, in human patients with T2D and established atherosclerotic cardiovascular disease (ASCVD) or high cardiovascular risk, the impact of guideline directed SGLT2i medication on physical performance has not been sufficiently examined.ObjectivesThe main objectives of this study are thus firstly, to assess the changes in physical performance after 4 weeks of exercise therapy in patients with established ASCVD or high cardiovascular risk categorized into three groups according to their glycemic control at baseline. Secondly, to investigate the association of glycemic control at baseline and new guideline directed antidiabetic treatment (inadequate glycemic control and diabetes + new SGLT2i vs. adequate glycemic control and diabetes vs. no diabetes) with change in physical performance.Methods and designThis is a 4-week prospective observational study of 450 participants with established ASCVD or high cardiovascular risk with or without T2D and without previous SGLT2i medication undergoing exercise therapy during inpatient rehabilitation in a single center in Switzerland. Upon admission, participants are categorized into 3 groups of 150 participants each according to their glycemic control. Group I consisting of participants with inadequately controlled T2D defined as mean fasting plasma glucose (FPG) of ≥7 mmol/L, who are consequently administered new treatment with an SGLT2i. Group II comprises of participants with adequately controlled T2D with mean FPG of <7 mmol/L requiring no antidiabetic medication change. Group III consists of participants with no diabetes and mean FPG of ≤ 5.5 mmol/L. Primary outcomes are 6-min walk distance and rate of perceived exertion. Secondary outcomes are echocardiographic parameters (left ventricular mass index; global longitudinal strain average; end-diastolic volume), fatigue, muscle, metabolic, and anthropometric measures.Ethics and disseminationThis study is conducted in accordance with the Declaration of Helsinki with ethical approval from the Cantonal Ethical Commission of Bern, Switzerland. The results will be published in a peer-reviewed journal. The implementation and reporting will be according to the SPIRIT guidelines.Study protocol registrationhttps://www.clinicaltrials.gov/, identifier: NCT03422263.

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Type 2 Diabetes Mellitus, Glycated Hemoglobin Levels, and Cardiopulmonary Exercise Capacity in Patients With Ischemic Heart Disease

Cited by 7 publications

References 24 publications

WITHDRAWN: The Effect of Mobile Health Intervention on Adherence to a Healthy Lifestyle in Patients with Cardiac Syndrome X (CSX)

WITHDRAWN: The Effect of Mobile Health Intervention on Adherence to a Healthy Lifestyle in Patients with Cardiac Syndrome X (CSX)

Effect of empagliflozin on left ventricular contractility and peak oxygen uptake in subjects with type 2 diabetes without heart disease: results of the EMPA-HEART trial

Physical performance and glycemic control under SGLT-2-inhibitors in patients with type 2 diabetes and established atherosclerotic cardiovascular diseases or high cardiovascular risk (PUSH): Design of a 4-week prospective observational study

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