Mechanisms of reduced peak oxygen consumption in subjects with uncomplicated type 2 diabetes
| Autor: | Matteo Mazzola, Lorenzo Nesti, Iacopo Fabiani, Nicolò De Biase, Domenico Tricò, Nicola Riccardo Pugliese, Andrea Natali, Paolo Sciuto, Stefano Masi |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
Cardiac output Diabetic Cardiomyopathies Endocrinology Diabetes and Metabolism Speckle tracking echocardiography Type 2 diabetes Diabetic cardiomyopathy Ventricular Function Left Prevalence Medicine Prospective Studies Original Investigation Aged 80 and over education.field_of_study Exercise Tolerance Middle Aged medicine.anatomical_structure Heart failure with preserved ejection fraction Italy Cardiology Female medicine.symptom Cardiology and Cardiovascular Medicine Echocardiography Stress Adult medicine.medical_specialty Systole Population Asymptomatic Oxygen Consumption Cardiopulmonary exercise test Effort intolerance Exercise physiology Internal medicine Humans Diseases of the circulatory (Cardiovascular) system Muscle Skeletal education Aged business.industry Stroke Volume medicine.disease Oxygen Cross-Sectional Studies Diabetes Mellitus Type 2 Case-Control Studies Heart failure RC666-701 Exercise Test Vascular resistance business Biomarkers |
| Zdroj: | Cardiovascular Diabetology, Vol 20, Iss 1, Pp 1-13 (2021) Cardiovascular Diabetology |
| ISSN: | 1475-2840 |
| Popis: | Background Type 2 diabetes mellitus (T2D) increases the risk of incident heart failure (HF), whose earliest fingerprint is effort intolerance (i.e. impaired peak oxygen consumption, or VO2peak). In the uncomplicated T2D population, however, the prevalence of effort intolerance and the underpinning mechanistic bases are uncertain. Leveraging the multiparametric characterization allowed by imaging-cardiopulmonary exercise testing (iCPET), the aim of this study is to quantify effort intolerance in T2D and to dissect the associated cardiopulmonary alterations. Methods Eighty-eight adults with well-controlled and uncomplicated T2D and no criteria for HF underwent a maximal iCPET with speckle tracking echocardiography, vascular and endothelial function assessment, as well as a comprehensive biohumoral characterization. Effort intolerance was defined by a VO2peak below 80% of maximal predicted oxygen uptake. Results Forty-eight patients (55%) had effort intolerance reaching a lower VO2peak than T2D controls (16.5 ± 3.2 mL/min/kg, vs 21.7 ± 5.4 mL/min/kg, p 2/work slope (9.9 ± 1.2 vs 11.2 ± 1.4, p 2peak above 80%. Diastolic function, vascular resistance, endothelial function, biohumoral exams, right heart and pulmonary function indices did not differ between the two groups. Conclusions Effort intolerance and reduced VO2peak is a severe and highly prevalent condition in uncomplicated, otherwise asymptomatic T2D. It results from a major defect in skeletal muscle oxygen extraction coupled with a subtle myocardial systolic dysfunction. |
| Databáze: | OpenAIRE |
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