Asymptomatic type 2 diabetes mellitus display a reduced myocardial deformation but adequate response during exercise

Ryckeghem, Lisa Van; Keytsman, Charly; Verbaanderd, Elvire; Frederix, Ines; Bakelants, Elise; Petit, Thibault; Jogani, Siddharth; Stroobants, Sarah; Dendale, Paul; Bito, Virginie; Verwerft, Jan; Hansen, Dominique

doi:10.1007/s00421-020-04557-5

Cited by 4 publications

(1 citation statement)

References 39 publications

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“…Diabetic cardiomyopathy is characterized by two distinct phenotypes, LV dilatation with systolic dysfunction or concentric LV hypertrophy with diastolic dysfunction ( 86 ). Glycemic control has been shown to influence cardiac function in individuals with diabetes ( 87 ), however, even individuals with well-controlled diabetes (defined by HbA1c < 7.5%) have subclinical myocardial dysfunction demonstrated by a significantly reduced longitudinal strain reserve on stress echocardiography ( 88 ). A systematic review of exercise training in individuals with diabetes suggested an improvement in diastolic function (E/A) but no consistent effect on systolic function or LV remodeling on echocardiography or MRI ( 71 ).…”

Section: Exercise Training Effects On Cardiac Structure and Function ...mentioning

confidence: 99%

A Contemporary Review of the Effects of Exercise Training on Cardiac Structure and Function and Cardiovascular Risk Profile: Insights From Imaging

Alhumaid

Small

Kirkham

et al. 2022

Front. Cardiovasc. Med.

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Exercise is a commonly prescribed therapy for patients with established cardiovascular disease or those at high risk for de novo disease. Exercise-based, multidisciplinary programs have been associated with improved clinical outcomes post myocardial infarction and is now recommended for patients with cancer at elevated risk for cardiovascular complications. Imaging studies have documented numerous beneficial effects of exercise on cardiac structure and function, vascular function and more recently on the cardiovascular risk profile. In this contemporary review, we will discuss the effects of exercise training on imaging-derived cardiovascular outcomes. For cardiac imaging via echocardiography or magnetic resonance, we will review the effects of exercise on left ventricular function and remodeling in patients with established or at risk for cardiac disease (myocardial infarction, heart failure, cancer survivors), and the potential utility of exercise stress to assess cardiac reserve. Exercise training also has salient effects on vascular function and health including the attenuation of age-associated arterial stiffness and thickening as assessed by Doppler ultrasound. Finally, we will review recent data on the relationship between exercise training and regional adipose tissue deposition, an emerging marker of cardiovascular risk. Imaging provides comprehensive and accurate quantification of cardiac, vascular and cardiometabolic health, and may allow refinement of risk stratification in select patient populations. Future studies are needed to evaluate the clinical utility of novel imaging metrics following exercise training.

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Section: Exercise Training Effects On Cardiac Structure and Function ...mentioning

confidence: 99%

A Contemporary Review of the Effects of Exercise Training on Cardiac Structure and Function and Cardiovascular Risk Profile: Insights From Imaging

Alhumaid

Small

Kirkham

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

show abstract

Diabetic microvascular complications are associated with left atrial structural alterations in asymptomatic type 2 diabetes patients: A cross-sectional study

Gong

Meng

et al. 2023

Journal of Diabetes and its Complications

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Pulmonary hypertension during exercise underlies unexplained exertional dyspnoea in patients with Type 2 diabetes

Gojevic

Ryckeghem

Jogani

et al. 2022

European Journal of Preventive Cardiology

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Aim To compare the cardiac function and pulmonary vascular function during exercise between dyspneic and non-dyspneic patients with type 2 diabetes mellitus (T2DM). Methods 47 T2DM patients with unexplained dyspnea and 50 asymptomatic T2DM patients underwent exercise echocardiography combined with ergospirometry. Left ventricular (LV) function (stroke volume, cardiac output, LV ejection fraction, systolic annular velocity (s’)), estimated LV filling pressures (E/e’), mean pulmonary arterial pressures (mPAP) and mPAP/COslope were assessed at rest, low- and high-intensity exercise with colloid contrast. Results Groups had similar patient characteristics, glycemic control, stroke volume, cardiac output, LV ejection fraction and E/e’ (p > 0.05). The dyspneic group had significantly lower systolic LV reserve at peak exercise (s’) (p = 0.021) with a significant interaction effect (p < 0.001). The dyspneic group also had significantly higher mPAP and mPAP/CO at rest and exercise (p < 0.001) with significant interaction for mPAP (p < 0.009) and insignificant for mPAP/CO (p = 0.385). There was no significant difference in mPAP/COslope between groups (p = 0.706). However, about 61% of dyspneic vs. 30% of non-dyspneic group had mPAP/COslope > 3 (p = 0.009). The mPAP/COslope negatively predicted V̇O2peak in dyspneic group (β= -1.86, 95% CI -2.75, -0.98; multivariate model R²:0.54). Conclusion Pulmonary hypertension and less LV systolic reserve detected by exercise echocardiography with colloid contrast underlie unexplained exertional dyspnea and reduced exercise capacity in T2DM.

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Asymptomatic type 2 diabetes mellitus display a reduced myocardial deformation but adequate response during exercise

Cited by 4 publications

References 39 publications

A Contemporary Review of the Effects of Exercise Training on Cardiac Structure and Function and Cardiovascular Risk Profile: Insights From Imaging

A Contemporary Review of the Effects of Exercise Training on Cardiac Structure and Function and Cardiovascular Risk Profile: Insights From Imaging

Diabetic microvascular complications are associated with left atrial structural alterations in asymptomatic type 2 diabetes patients: A cross-sectional study

Pulmonary hypertension during exercise underlies unexplained exertional dyspnoea in patients with Type 2 diabetes

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