PMID- 33417036 OWN - NLM STAT- MEDLINE DCOM- 20211102 LR - 20211102 IS - 1439-6327 (Electronic) IS - 1439-6319 (Linking) VI - 121 IP - 3 DP - 2021 Mar TI - Asymptomatic type 2 diabetes mellitus display a reduced myocardial deformation but adequate response during exercise. PG - 929-940 LID - 10.1007/s00421-020-04557-5 [doi] AB - BACKGROUND AND PURPOSE: The development of myocardial fibrosis is a major complication of Type 2 diabetes mellitus (T2DM), impairing myocardial deformation and, therefore, cardiac performance. It remains to be established whether abnormalities in longitudinal strain (LS) exaggerate or only occur in well-controlled T2DM, when exposed to exercise and, therefore, cardiac stress. We therefore studied left ventricular LS at rest and during exercise in T2DM patients vs. healthy controls. METHODS AND RESULTS: Exercise echocardiography was applied with combined breath-by-breath gas exchange analyses in asymptomatic, well-controlled (HbA1c: 6.9 +/- 0.7%) T2DM patients (n = 36) and healthy controls (HC, n = 23). Left ventricular LS was assessed at rest and at peak exercise. Peak oxygen uptake (V̇O(2peak)) and workload (W(peak)) were similar between groups (p > 0.05). Diastolic (E, e'(s), E/e') and systolic function (left ventricular ejection fraction) were similar at rest and during exercise between groups (p > 0.05). LS (absolute values) was significantly lower at rest and during exercise in T2DM vs. HC (17.0 +/- 2.9% vs. 19.8 +/- 2% and 20.8 +/- 4.0% vs. 23.3 +/- 3.3%, respectively, p < 0.05). The response in myocardial deformation (the change in LS from rest up to peak exercise) was similar between groups (+ 3.8 +/- 0.6% vs. + 3.6 +/- 0.6%, in T2DM vs. HC, respectively, p > 0.05). Multiple regression revealed that HDL-cholesterol, fasted insulin levels and exercise tolerance accounted for 30.5% of the variance in response of myocardial deformation in the T2DM group (p = 0.002). CONCLUSION: Myocardial deformation is reduced in well-controlled T2DM and despite adequate responses, such differences persist during exercise. TRIAL REGISTRATION: NCT03299790, initially released 09/12/2017. FAU - Van Ryckeghem, Lisa AU - Van Ryckeghem L AD - REVAL-Rehabilitation Research Centre, Faculty of Rehabilitation Sciences, Hasselt University, Agoralaan, Building A, 3590, Diepenbeek, Belgium. lisa.vanryckeghem@uhasselt.be. AD - BIOMED-Biomedical Research Centre, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium. lisa.vanryckeghem@uhasselt.be. FAU - Keytsman, Charly AU - Keytsman C AUID- ORCID: 0000-0001-7070-9515 AD - REVAL-Rehabilitation Research Centre, Faculty of Rehabilitation Sciences, Hasselt University, Agoralaan, Building A, 3590, Diepenbeek, Belgium. AD - BIOMED-Biomedical Research Centre, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium. FAU - Verbaanderd, Elvire AU - Verbaanderd E AD - Physical Activity, Sport & Health Research Group, Faculty of Movement Sciences, KU Leuven, Leuven, Belgium. FAU - Frederix, Ines AU - Frederix I AD - BIOMED-Biomedical Research Centre, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium. AD - Department of Cardiology, Virga Jessa Hospital, Heart Centre Hasselt, Hasselt, Belgium. AD - Faculty of Medicine & Health Sciences, Antwerp University, Antwerp, Belgium. AD - Department of Cardiology, Antwerp University Hospital, Edegem, Belgium. FAU - Bakelants, Elise AU - Bakelants E AD - Department of Cardiology, Virga Jessa Hospital, Heart Centre Hasselt, Hasselt, Belgium. AD - Hopitaux Universitaires de Geneve (HUG), Geneve, Switzerland. FAU - Petit, Thibault AU - Petit T AD - Department of Cardiology, Virga Jessa Hospital, Heart Centre Hasselt, Hasselt, Belgium. AD - Department of Cardiology, Hospital Oost-Limburg, Genk, Belgium. FAU - Jogani, Siddharth AU - Jogani S AD - Department of Cardiology, Virga Jessa Hospital, Heart Centre Hasselt, Hasselt, Belgium. FAU - Stroobants, Sarah AU - Stroobants S AD - Department of Cardiology, Virga Jessa Hospital, Heart Centre Hasselt, Hasselt, Belgium. FAU - Dendale, Paul AU - Dendale P AD - BIOMED-Biomedical Research Centre, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium. AD - Department of Cardiology, Virga Jessa Hospital, Heart Centre Hasselt, Hasselt, Belgium. FAU - Bito, Virginie AU - Bito V AUID- ORCID: 0000-0003-0986-7906 AD - BIOMED-Biomedical Research Centre, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium. FAU - Verwerft, Jan AU - Verwerft J AD - Department of Cardiology, Virga Jessa Hospital, Heart Centre Hasselt, Hasselt, Belgium. FAU - Hansen, Dominique AU - Hansen D AUID- ORCID: 0000-0003-3074-2737 AD - REVAL-Rehabilitation Research Centre, Faculty of Rehabilitation Sciences, Hasselt University, Agoralaan, Building A, 3590, Diepenbeek, Belgium. AD - BIOMED-Biomedical Research Centre, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium. AD - Department of Cardiology, Virga Jessa Hospital, Heart Centre Hasselt, Hasselt, Belgium. LA - eng SI - ClinicalTrials.gov/NCT03299790 PT - Journal Article DEP - 20210108 PL - Germany TA - Eur J Appl Physiol JT - European journal of applied physiology JID - 100954790 SB - IM MH - Adolescent MH - Adult MH - Aged MH - Aged, 80 and over MH - Belgium/epidemiology MH - Cardiomyopathies/epidemiology/pathology/*physiopathology MH - Cross-Sectional Studies MH - Diabetes Mellitus, Type 2/epidemiology/pathology/*physiopathology MH - Exercise Tolerance/*physiology MH - Female MH - Humans MH - Male MH - Middle Aged MH - Stroke Volume MH - Ventricular Dysfunction, Left/epidemiology/*pathology MH - Young Adult OTO - NOTNLM OT - Exercise tests OT - Left ventricular longitudinal strain OT - Stress echocardiography OT - Type 2 diabetes mellitus EDAT- 2021/01/09 06:00 MHDA- 2021/11/03 06:00 CRDT- 2021/01/08 12:14 PHST- 2020/04/27 00:00 [received] PHST- 2020/11/07 00:00 [accepted] PHST- 2021/01/09 06:00 [pubmed] PHST- 2021/11/03 06:00 [medline] PHST- 2021/01/08 12:14 [entrez] AID - 10.1007/s00421-020-04557-5 [pii] AID - 10.1007/s00421-020-04557-5 [doi] PST - ppublish SO - Eur J Appl Physiol. 2021 Mar;121(3):929-940. doi: 10.1007/s00421-020-04557-5. Epub 2021 Jan 8.