Neutral impact on systolic and diastolic cardiac function of 2 years of intensified multi-intervention in type 2 diabetes: The randomized controlled Asker and Bærum Cardiovascular Diabetes (ABCD) study

Ofstad, Anne Pernille; Johansen, Odd Erik; Gullestad, Lars; Birkeland, Kåre I.; Orvik, Elsa; Fagerland, Morten Wang; Urheim, Stig; Aakhus, Svend

doi:10.1016/j.ahj.2014.03.026

Cited by 15 publications

(9 citation statements)

References 29 publications

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“…Our results are in line with this, showing that the risk of heart failure hospitalization was not as closely associated with the number of risk factors controlled. This is supported by a mechanistic study showing no impact on cardiac function of a 2-year multifactorial intervention targeting lifestyle intervention, hyperglycemia, hypertension, and dyslipidemia in T2D patients ( 44 ). These findings can be explained by potential nontraditional, unmeasured risk factors that play a bigger role in heart failure events than atherosclerotic outcomes ( 44 ).…”

Section: Discussionmentioning

confidence: 80%

“…This is supported by a mechanistic study showing no impact on cardiac function of a 2-year multifactorial intervention targeting lifestyle intervention, hyperglycemia, hypertension, and dyslipidemia in T2D patients ( 44 ). These findings can be explained by potential nontraditional, unmeasured risk factors that play a bigger role in heart failure events than atherosclerotic outcomes ( 44 ). As neither glucose-lowering ( 45 ) nor lipid-lowering ( 46 ) per se have shown treatment benefit for heart failure, therapeutic options are limited.…”

Section: Discussionmentioning

confidence: 80%

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Cardiovascular Benefit of Empagliflozin Across the Spectrum of Cardiovascular Risk Factor Control in the EMPA-REG OUTCOME Trial

Inzucchi

Khunti

Fitchett

et al. 2020

The Journal of Clinical Endocrinology &Amp; Metabolism

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CONTEXT Control of multiple cardiovascular (CV) risk factors reduces CV events in individuals with type 2 diabetes (T2D). OBJECTIVE To investigate this association in a contemporary clinical trial population, including how CV risk factor control affects the CV benefits of empagliflozin, a sodium-glucose co-transporter-2 inhibitor. DESIGN Post hoc analysis SETTING Randomized CV outcomes trial (EMPA-REG OUTCOME). INTERVENTION Empagliflozin or placebo. MAIN OUTCOME MEASURES Risk of CV outcomes – including treatment effect of empagliflozin – by achievement of seven goals for CV risk factor control at baseline: glycated hemoglobin <7.5%, low-density lipoprotein cholesterol <100 mg/dL or statin use, systolic blood pressure <140 mmHg and diastolic blood pressure <90 mmHg, pharmacological renin-angiotensin-aldosterone system blockade, normoalbuminuria, aspirin use, non-smoking. RESULTS In the placebo group, the hazard ratio (HR) for CV death was 4.00 (95% CI 2.26–7.11) and 2.48 (1.52–4.06) for patients achieving only 0–3 or 4–5 risk factor goals at baseline, respectively, compared to those achieving 6–7 goals. Participants achieving 0–3 or 4–5 goals also had increased risk for the composite outcome of hospitalization for heart failure or CV death (excluding fatal stroke) (HR 2.89 [1.82–4.57] and 1.90 [1.31–2.78], respectively) and 3-point major adverse CV events (HR 2.21 [1.53–3.19] and 1.42 [1.06–1.89]). Empagliflozin significantly reduced these outcomes across all risk factor control categories (P>0.05 for treatment-by-subgroup interactions). CONCLUSIONS CV risk in EMPA-REG OUTCOME was inversely associated with baseline CV risk factor control. Empagliflozin’s cardioprotective effect was consistent regardless of multiple baseline risk factor control.

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 80%

Cardiovascular Benefit of Empagliflozin Across the Spectrum of Cardiovascular Risk Factor Control in the EMPA-REG OUTCOME Trial

Inzucchi

Khunti

Fitchett

et al. 2020

The Journal of Clinical Endocrinology &Amp; Metabolism

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“…A 10% increase in peak O 2 pulse, which is an estimate of peak left ventricular stroke volume (Whipp et al 1996), has been observed after three months of aerobic training in type 1 diabetes adults (Rigla et al 2000). In addition, echocardiography studies in patients with type 2 diabetes have produced contradictory findings: Both training-induced improvements (Hollekim-Strand et al 2014) and no improvements (Ofstad et al 2014) in myocardial function have been observed with high training intensity possibly leading to more pronounced effects (Hollekim-Strand et al 2014). In the current study, peak O 2 pulse rose in a similar manner in the training groups (T1D: 10%, CON: 11%) after the long-term one-year exposure to regular exercise, suggesting a similar improvement in cardiac pump function in the groups.…”

Section: Discussionmentioning

confidence: 95%

One-year unsupervised individualized exercise training intervention enhances cardiorespiratory fitness but not muscle deoxygenation or glycemic control in adults with type 1 diabetes

Rissanen

Tikkanen

Koponen

et al. 2018

Appl. Physiol. Nutr. Metab.

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Adaptations to long-term exercise training in type 1 diabetes are sparsely studied. We examined the effects of a 1-year individualized training intervention on cardiorespiratory fitness, exercise-induced active muscle deoxygenation, and glycemic control in adults with and without type 1 diabetes. Eight men with type 1 diabetes (T1D) and 8 healthy men (CON) matched for age, anthropometry, and peak pulmonary O2 uptake, completed a 1-year individualized training intervention in an unsupervised real-world setting. Before and after the intervention, the subjects performed a maximal incremental cycling test, during which alveolar gas exchange (volume turbine and mass spectrometry) and relative concentration changes in active leg muscle deoxygenated (Δ[HHb]) and total (Δ[tHb]) hemoglobin (near-infrared spectroscopy) were monitored. Peak O2 pulse, reflecting peak stroke volume, was calculated (peak pulmonary O2 uptake/peak heart rate). Glycemic control (glycosylated hemoglobin A1c (HbA1c)) was evaluated. Both T1D and CON averagely performed 1 resistance-training and 3–4 endurance-training sessions per week (∼1 h/session at ∼moderate intensity). Training increased peak pulmonary O2 uptake in T1D (p = 0.004) and CON (p = 0.045) (group × time p = 0.677). Peak O2 pulse also rose in T1D (p = 0.032) and CON (p = 0.018) (group × time p = 0.880). Training increased leg Δ[HHb] at peak exercise in CON (p = 0.039) but not in T1D (group × time p = 0.052), while no changes in leg Δ[tHb] at any work rate were observed in either group (p > 0.05). HbA1c retained unchanged in T1D (from 58 ± 10 to 59 ± 11 mmol/mol, p = 0.609). In conclusion, 1-year adherence to exercise training enhanced cardiorespiratory fitness similarly in T1D and CON but had no effect on active muscle deoxygenation or glycemic control in T1D.

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“…En personas con DM y sobrepeso u obesidad, indicar un plan alimentario hipocalórico y actividad física regular para lograr y mantener un peso saludable 115 , mejorar el control glucémico y reducir los FRCV 116 .…”

Section: Prevención De Ic En Pacientes Con Dm2unclassified

Mesa 2: Insuficiencia cardíaca y diabetes mellitus tipo 2

Méndez

Martı́n²,

Remón

et al. 2020

Rev. Soc. Argent. Diabetes

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Desde que el estudio Framingham en 1974 reportó un aumento de dos a cinco veces en el riesgo de desarrollar insuficiencia cardíaca (IC) en pacientes con diabetes mellitus (DM), otros estudios observacionales confirmaron esta asociación que ha tomado gran visibilidad en los últimos años a partir de los resultados de los estudios de seguridad cardiovascular de las drogas antidiabéticas.La IC se define como un síndrome clínico que resulta del deterioro funcional o estructural del llenado ventricular o la eyección de sangre. Puede clasificarse según la fracción de eyección, la presencia de síntomas y la limitación de la actividad física.Existen distintos factores asociados a la IC en personas con DM como la edad, la antigüedad de la enfermedad, la utilización de insulina, la enfermedad coronaria, la hipertensión arterial, la enfermedad arterial periférica, el aumento de creatinina, el escaso control glucémico, la albuminuria y la obesidad. A su vez la IC se asocia a insulinorresistencia y a estados disglucémicos que se consideran de riesgo para el desarrollo de DM.

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Neutral impact on systolic and diastolic cardiac function of 2 years of intensified multi-intervention in type 2 diabetes: The randomized controlled Asker and Bærum Cardiovascular Diabetes (ABCD) study

Cited by 15 publications

References 29 publications

Cardiovascular Benefit of Empagliflozin Across the Spectrum of Cardiovascular Risk Factor Control in the EMPA-REG OUTCOME Trial

Cardiovascular Benefit of Empagliflozin Across the Spectrum of Cardiovascular Risk Factor Control in the EMPA-REG OUTCOME Trial

One-year unsupervised individualized exercise training intervention enhances cardiorespiratory fitness but not muscle deoxygenation or glycemic control in adults with type 1 diabetes

Mesa 2: Insuficiencia cardíaca y diabetes mellitus tipo 2

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