Cardiac Function and Exercise Capacity of Diabetic Patients

  • UCHIMOTO Sadahiko
    Second Department of Internal Medicine, Osaka City University Medical School
  • TSUMURA Kei
    Second Department of Internal Medicine, Osaka City University Medical School
  • YAMASHITA Naotoshi
    Second Department of Internal Medicine, Osaka City University Medical School
  • KISHIMOTO Hiroshi
    Second Department of Internal Medicine, Osaka City University Medical School
  • FUJIOKA Shoji
    Second Department of Internal Medicine, Osaka City University Medical School
  • IZUMOTANI Kyoko
    Second Department of Internal Medicine, Osaka City University Medical School
  • MORII Hirotoshi
    Second Department of Internal Medicine, Osaka City University Medical School

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Abstract

To evaluate the relationship between cardiac function at rest and the exercise capacity of diabetic patients, left ventricular function and exercise capacity were evaluated in 15 non-insulin-dependent male diabetic patients. Isovolumic relaxation time (IRT) and the PEP/LVET ratio were obtained by simultaneous echophonocardiograms, electrocardiograms, and recordings of the carotid arterial pulse. VO2 at anaerobic threshold was obtained from a cycle ergometer exercise test with expired gas analysis. Patients were divided into two groups: those with IRT<90 msec (Group 1) and those with IRT≥90 msec (Group 2). Group 2 patients had a lower VO2 at anaerobic threshold than Group 1 (Group 1:17.4±3.6, Group 2:12.9±2.5ml/min/kg; M±SD, p<0.05). There was a good correlation between the IRT at rest and ΔHR, defined as the change in heart rate from rest to anaerobic threshold (r=0.666, p<0.01), and between ΔHR and the beat-to-beat variation in R-R interval at rest (r=0.637, p<0.02). There was also a good correlation between VO2 at anaerobic threshold and IRT (r=0.555, p<0.05), and between VO2 at anaerobic threshold and ΔHR (r=0.858, p<0.01). Our data suggests that both left ventricular diastolic function and cardiac sympathetic nervous system reflexes, reflected by ΔHR, may affect the exercise capacity of diabetic patients. Thus, IRT obtained by a non-invasive method may provide a useful index for cardiovascular response to exercise in diabetic patients without coronary artery disease.

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