Open AccessLeft ventricular function and exercise tolerance in patients with type ii diabetes mellitus
Author(s) -
Irace Luigi,
Iarussi Diana,
Guadagno Immacolata,
De Rimini Maria Luisa,
Mansi Luigi,
Lucca Pasqualijna,
Spadaro Pasquale,
Romano Ada,
Iacono Aldo
Publication year - 1998
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960210807
Subject(s) - medicine , cardiology , preload , blood pressure , basal (medicine) , diastole , diabetes mellitus , doppler echocardiography , left ventricular hypertrophy , hemodynamics , endocrinology , insulin
Background : Left ventricular (LV) preload changes may alter exercise tolerance (ET), probably lessening activation of the Maestrini‐Starling mechanism. Reduced LV filling (preload) during the diastolic phase, usually impaired in diabetic patients, could affect ventricular function. Hypothesis : To evaluate the relationship between some echocardiographic LV function indices and ET, 24 patients (age 43‐75 years, mean 54 ± 13 years, Group A) with type II diabetes mellitus (DM), not suffering from other pathologies, and for whom the ergometric stress test (EST) resulted in an early interruption because of muscular fatigue and/or dyspnea, and 14 patients (age 38‐70 years, mean 53 ± 12 years, Group B) with type II DM and maximal ergometric stress test, used as control group, were studied. Methods : The EST was performed by increasing the load by 25 W every 2 min; its duration was used as an ET index and correlated with clinical parameters of LV function obtained with M‐mode, two‐dimensional, and Doppler echocardiography. Results : No patient in either Group A or Group B showed a high systolic blood pressure value at rest and/or an LV hypertrophy and/or an alteration of systolic functional indices. In neither group was there significant correlation between ET and duration of DM, basal heart rate, basal and max systolic blood pressure, and EF values. Linear regression analysis showed a significant correlation between Doppler parameters of the diastolic function and ET index in Group A, while there was no significant correlation inGroup B. Conclusion : From these data we can deduce that in absence of left systolic ventricular dysfunction the impairment of LV relaxation in DM can influence exercise tolerance, probably by limiting activation of the contractile reserve.