Functional capacity and left ventricular diastolic function in patients with type 2 diabetes
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ORIGINAL ARTICLE
Functional capacity and left ventricular diastolic function in patients with type 2 diabetes Marijana Tadic1 · Jelena Suzic‑Lazic1 · Vladan Vukomanovic1 · Cesare Cuspidi2 · Sanja Ilic3 · Vera Celic1 Received: 14 July 2020 / Accepted: 26 August 2020 © Springer-Verlag Italia S.r.l., part of Springer Nature 2020
Abstract Aims The study sought to evaluate cardiorespiratory fitness in patients with type 2 diabetes mellitus (DM) with different levels of left ventricular (LV) diastolic dysfunction (LVDD). Methods This investigation included 55 controls and 85 uncomplicated diabetic patients, who underwent laboratory analysis, echocardiographic evaluation and cardiopulmonary exercise testing. All DM subjects were separated into 3 groups using the level of LV diastolic function as main criterion: normal, intermediate and LVDD. Results Echocardiographic parameters of LV hypertrophy were significantly higher in DM subjects, particularly those with intermediate LV diastolic function and LVDD comparing with controls. The same is valid for parameters of LV diastolic function (E/e′, left atrial volume index and tricuspid regurgitation velocity). Peak oxygen uptake was lower, whereas ventilation/carbon dioxide slope was higher, in DM subjects with intermediate LV diastolic function and LVDD in comparison to controls. In the whole study population HbA1c, LV mass index and mitral E/e′ were independently related with peak oxygen uptake and ventilation/carbon dioxide slope. Conclusions LVDD significantly impacted functional capacity in DM patients. Glycemic control, LV mass index and LVDD were independently related with peak oxygen consumption and ventilation/carbon dioxide slope in the study population. These results show that timely diagnosis of LVDD and more intensive antidiabetic treatment could prevent target organ damage in DM patients. Keywords Diabetes · Left ventricle · Diastolic dysfunction · Cardiopulmonary exercise testing
Introduction Type 2 diabetes mellitus (DM) is one of the most prevalent modifiable cardiovascular risk factors related with adverse cardiovascular outcome [1]. DM is related with impaired cardiac function and represents DM important risk factor Managed by Antonio Secchi. * Marijana Tadic [email protected] 1
Department of Cardiology, University Hospital “Dr. Dragisa Misovic - Dedinje”, Heroja Milana Tepica 1, 11000 Belgrade, Serbia
2
Clinical Research Unit, University of Milan-Bicocca and Istituto Auxologico Italiano IRCCS, Viale della Resistenza 23, 20036 Meda, Italy
3
Department of Endocrinology, University Hospital “Dr. Dragisa Misovic - Dedinje”, Heroja Milana Tepica 1, 11000 Belgrade, Serbia
responsible for occurrence of heart failure with preserved ejection fraction (HFpEF) [2], which has considerable high mortality risk. Echocardiographic evaluation of left ventricular (LV) diastolic function has been changed in the last guidelines and enabled better estimation of LV filling pressure measured by invasive methods [3, 4]. Deteriorated LV diastolic fu
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