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Impaired ventricular filling limits cardiac reserve during submaximal exercise in people with type 2 diabetes

BACKGROUND: Attenuated increases in ventricular stroke volume during exercise are common in type 2 diabetes and contribute to reduced aerobic capacity. The purpose of this study was to determine whether impaired ventricular filling or reduced systolic ejection were responsible for the attenuated str...

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Autores principales: Wilson, Genevieve A., Wilkins, Gerard T., Cotter, Jim D., Lamberts, Regis R., Lal, Sudish, Baldi, James C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5735887/
https://www.ncbi.nlm.nih.gov/pubmed/29258502
http://dx.doi.org/10.1186/s12933-017-0644-1
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author Wilson, Genevieve A.
Wilkins, Gerard T.
Cotter, Jim D.
Lamberts, Regis R.
Lal, Sudish
Baldi, James C.
author_facet Wilson, Genevieve A.
Wilkins, Gerard T.
Cotter, Jim D.
Lamberts, Regis R.
Lal, Sudish
Baldi, James C.
author_sort Wilson, Genevieve A.
collection PubMed
description BACKGROUND: Attenuated increases in ventricular stroke volume during exercise are common in type 2 diabetes and contribute to reduced aerobic capacity. The purpose of this study was to determine whether impaired ventricular filling or reduced systolic ejection were responsible for the attenuated stroke volume reserve in people with uncomplicated type 2 diabetes. METHODS: Peak aerobic capacity and total blood volume were measured in 17 people with diabetes and 16 non-diabetic controls with no evidence of cardiovascular disease. Left ventricular volumes and other systolic and diastolic functional parameters were measured with echocardiography at rest and during semi-recumbent cycle ergometry at 40 and 60% of maximal aerobic power and compared between groups. RESULTS: People with diabetes had reduced peak aerobic capacity and heart rate reserve, and worked at lower workloads than non-diabetic controls. Cardiac output, stroke volume and ejection fraction were not different at rest, but increased less in people with diabetes during exercise. Left ventricular end systolic volume was not different between groups in any condition but end diastolic volume, although not different at rest, was smaller in people with diabetes during exercise. Total blood volume was not different between the groups, and was only moderately associated with left ventricular volumes. CONCLUSIONS: People with type 2 diabetes exhibit an attenuated increase in stroke volume during exercise attributed to an inability to maintain/increase left ventricular filling volumes at higher heart rates. This study is the first to determine the role of filling in the blunted cardiac reserve in adults with type 2 diabetes. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12933-017-0644-1) contains supplementary material, which is available to authorized users.
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spelling pubmed-57358872017-12-21 Impaired ventricular filling limits cardiac reserve during submaximal exercise in people with type 2 diabetes Wilson, Genevieve A. Wilkins, Gerard T. Cotter, Jim D. Lamberts, Regis R. Lal, Sudish Baldi, James C. Cardiovasc Diabetol Original Investigation BACKGROUND: Attenuated increases in ventricular stroke volume during exercise are common in type 2 diabetes and contribute to reduced aerobic capacity. The purpose of this study was to determine whether impaired ventricular filling or reduced systolic ejection were responsible for the attenuated stroke volume reserve in people with uncomplicated type 2 diabetes. METHODS: Peak aerobic capacity and total blood volume were measured in 17 people with diabetes and 16 non-diabetic controls with no evidence of cardiovascular disease. Left ventricular volumes and other systolic and diastolic functional parameters were measured with echocardiography at rest and during semi-recumbent cycle ergometry at 40 and 60% of maximal aerobic power and compared between groups. RESULTS: People with diabetes had reduced peak aerobic capacity and heart rate reserve, and worked at lower workloads than non-diabetic controls. Cardiac output, stroke volume and ejection fraction were not different at rest, but increased less in people with diabetes during exercise. Left ventricular end systolic volume was not different between groups in any condition but end diastolic volume, although not different at rest, was smaller in people with diabetes during exercise. Total blood volume was not different between the groups, and was only moderately associated with left ventricular volumes. CONCLUSIONS: People with type 2 diabetes exhibit an attenuated increase in stroke volume during exercise attributed to an inability to maintain/increase left ventricular filling volumes at higher heart rates. This study is the first to determine the role of filling in the blunted cardiac reserve in adults with type 2 diabetes. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12933-017-0644-1) contains supplementary material, which is available to authorized users. BioMed Central 2017-12-19 /pmc/articles/PMC5735887/ /pubmed/29258502 http://dx.doi.org/10.1186/s12933-017-0644-1 Text en © The Author(s) 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Original Investigation
Wilson, Genevieve A.
Wilkins, Gerard T.
Cotter, Jim D.
Lamberts, Regis R.
Lal, Sudish
Baldi, James C.
Impaired ventricular filling limits cardiac reserve during submaximal exercise in people with type 2 diabetes
title Impaired ventricular filling limits cardiac reserve during submaximal exercise in people with type 2 diabetes
title_full Impaired ventricular filling limits cardiac reserve during submaximal exercise in people with type 2 diabetes
title_fullStr Impaired ventricular filling limits cardiac reserve during submaximal exercise in people with type 2 diabetes
title_full_unstemmed Impaired ventricular filling limits cardiac reserve during submaximal exercise in people with type 2 diabetes
title_short Impaired ventricular filling limits cardiac reserve during submaximal exercise in people with type 2 diabetes
title_sort impaired ventricular filling limits cardiac reserve during submaximal exercise in people with type 2 diabetes
topic Original Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5735887/
https://www.ncbi.nlm.nih.gov/pubmed/29258502
http://dx.doi.org/10.1186/s12933-017-0644-1
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