Why the study?
The impact of epicardial adipose tissue thickness on cardiopulmonary performance in patients with type 2 diabetes and normal heart function remained to be investigated.
Does higher epicardial adipose tissue thickness reduce cardiopulmonary performance and systolic reserve in patients with type 2 diabetes and normal heart function?
Does higher epicardial adipose tissue thickness reduce cardiopulmonary performance and systolic reserve in patients with type 2 diabetes and normal heart function?
Increased epicardial adipose tissue thickness in type 2 diabetes is associated with subclinical cardiac systolic dysfunction and reduced exercise capacity despite normal resting heart function.
Answers are grounded in this paper and cite their sources.
Higher EAT thickness may flag reduced exercise capacity in T2D; leaves open causal role and need for prospective trials.
Aim To investigate the impact of epicardial adipose tissue (EAT) thickness on cardiopulmonary performance in patients with type 2 diabetes (T2D) and normal heart function. Materials and methods We analysed EAT thickness in subjects with T2D and normal biventricular systo‐diastolic functions undergoing a maximal cardiopulmonary exercise test combined with stress echocardiography, speckle tracking and pulmonary function assessment, as well as serum N‐terminal pro B‐type natriuretic peptide (NT‐proBNP). Results In the 72 subjects enrolled, those with EAT thickness above the median (> 5 mm) showed higher body fat mass, smaller indexed left ventricular dimensions and marginally reduced diastolic function variables at rest. Higher EAT thickness was associated with lower peak oxygen uptake (VO 2peak 17.1 ± 3.6 vs. 21.0 ± 5.7 ml/min/kg, P = .001), reduced systolic reserve (ΔS′ 4.6 ± 1.6 vs. 5.8 ± 2.5 m/s, P = .02) and higher natriuretic peptides (NT‐proBNP 64 [29‐165] vs. 31 [26‐139] pg/ml, P = .04), as well as chronotropic insufficiency and impaired heart rate recovery. Ventilatory variables and peripheral oxygen extraction were not different between groups. EAT was independently associated with VO 2peak and linearly and negatively correlated with peak heart rate, heart rate recovery, workload, VO 2 at the anaerobic threshold and at peak, and cardiac power output, and was directly correlated with natriuretic peptides. Conclusion Higher EAT thickness in T2D is associated with worse cardiopulmonary performance and multiple traits of subclinical cardiac systolic dysfunction.
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Nesti et al. (2022) studied this question.
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