Key result
Asymptomatic diabetics show dramatically higher exercise filling pressures correlating with HbA1c and disease duration.
Why the study?
Subclinical LV dysfunction predicts heart failure, and diastolic exercise echocardiography is a relatively novel modality to detect latent diastolic dysfunction in diabetes presenting with exertional dyspnea.
Does exercise stress echocardiography detect subclinical diastolic dysfunction (raised filling pressure) in asymptomatic diabetics compared to normal volunteers?
Case-Control (n=70)
Does exercise stress echocardiography detect subclinical diastolic dysfunction (raised filling pressure) in asymptomatic diabetics compared to normal volunteers?
Exercise stress echocardiography can detect subclinical diastolic dysfunction in asymptomatic diabetics, which correlates with HbA1c, diabetes duration, waist circumference, and eGFR.
May detect subclinical diastolic dysfunction in asymptomatic diabetics; hypothesis-generating and requires prospective validation before clinical use.
Background:Subclinical left ventricular dysfunction is not uncommon and is a predictor of heart failure. Diabetes commonly presents with exertional dyspnea and reduced exercise tolerance, which is due to diastolic dysfunction. Diastolic exercise echocardiography is a relatively novel modality to detect latent diastolic dysfunction. Aim: We aimed to evaluate the different parameters that affect raised filling pressure during exercise in asymptomatic diabetics using exercise stress echocardiography. Subjects and Methods:This is a case-control study that included 70 persons (35 diabetics and 35 normal volunteers age and sex-matched) who had exertional dyspnea but were asymptomatic at rest. They had a normal systolic and diastolic functions at rest. They did treadmill exercise stress ECG. Post-peak stress images were obtained as quickly as possible after the patient transferred from the treadmill to the imaging table measuring the E/e' ratio. Results:Filling pressure raised dramatically in the diabetic group compared to non-diabetics. Using linear regression analysis, HbA1c as a continuous variable, duration of DM, and waist circumference showed a positive linear significant association with E/e’ during exercise. Conclusion:HbA1c level, duration of DM, waist circumference, and eGFR are related to subclinical diastolic dysfunction in asymptomatic diabetics during exercise.
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Fareed et al. (2023) conducted a case-control in Diabetes (n=70). Exercise stress echocardiography vs. Normal volunteers was evaluated on E/e' ratio during exercise. Exercise stress echocardiography revealed dramatically higher filling pressures in asymptomatic diabetics versus non-diabetics, correlating with HbA1c, diabetes duration, and waist circumference.
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