Type 2 diabetic patients with diastolic dysfunction demonstrated a significantly reduced exercise capacity (396 seconds) compared to diabetic patients without diastolic dysfunction (487 seconds) and healthy controls (519 seconds).
Observational (n=70)
Does treadmill exercise reveal worsening diastolic dysfunction and reduced exercise capacity in type 2 diabetic patients with baseline diastolic dysfunction compared to those without?
In type 2 diabetic patients with baseline diastolic dysfunction, exercise induces a pseudo-normal filling pattern and significantly increases left ventricular filling pressures (E/Em), leading to reduced exercise capacity.
Absolute Event Rate: 396% vs 487%
p-value: p=0.01
BACKGROUND: The aim of this study was to evaluate the relationship between changes in diastolic functions during exercise and the exercising capacity in diabetic patients with diastolic dysfunction and to compare them with healthy individuals and diabetic patients without diastolic dysfunction. METHODS: Totally 70 patients prospectively were included in the study and three groups were formed. Forty-six diabetic patients were divided into two groups: those with (group 1) and without (group 2) diastolic dysfunction. The control group (group 3) consisted of 24 patients. All patients were subjected to treadmill exercising test. Echocardiographical assessment was made before exercise and immediately after peak exercise. RESULTS: Exercising time was dramatically decreased in group 1 compared to the other groups (group 1: 396 ± 125 second, group 2: 487 ± 66 second and group 3: 519 ± 102 second). In group 1, the diastolic mitral flow pattern at rest was transformed into pseudo-normal pattern at peak exercise from abnormal relaxation pattern (E/A ratio 0.70 ± 0.11 during rest, 1.02 ± 0.16; P < 0.0001 during peak exercise). Deceleration time (DT) and iso-volumetric relaxation time (IVRT) turned to normal values (DT 238.86 ± 39.48 millisecond during rest and 199.5 ± 23.57 millisecond during peak exercise; P = 0.001, IVRT 102.83 ± 16.22 millisecond during rest and 74.36 ± 8.67 millisecond during peak exercise; P = 0.001). In groups 2 and 3, the mitral flow pattern, DT and IVRT remained within normal limits during rest and exercise. E/Em ratio, which is one of the parameters of tissue Doppler, increased during peak exercise in the diabetic group with diastolic dysfunction (E/Em ratio 7.85 ± 3.31 during rest and 11.14 ± 3.40 after peak exercise; P < 0.0001). CONCLUSIONS: Diabetic patients with diastolic dysfunction demonstrated a reduced exercise capacity, which may be due to aggravation of pre-existing left ventricular dysfunction.
Özkan et al. (Thu,) conducted a observational in Type 2 Diabetes Mellitus (n=70). Type 2 diabetes with diastolic dysfunction vs. Type 2 diabetes without diastolic dysfunction and healthy controls was evaluated on Exercise time (seconds) (p=0.01). Type 2 diabetic patients with diastolic dysfunction demonstrated a significantly reduced exercise capacity (396 seconds) compared to diabetic patients without diastolic dysfunction (487 seconds) and healthy controls (519 seconds).