PMID- 35881689
OWN - NLM
STAT- MEDLINE
DCOM- 20230113
LR  - 20230325
IS  - 2047-4881 (Electronic)
IS  - 2047-4873 (Linking)
VI  - 30
IP  - 1
DP  - 2023 Jan 11
TI  - Pulmonary hypertension during exercise underlies unexplained exertional dyspnoea 
      in patients with Type 2 diabetes.
PG  - 37-45
LID - 10.1093/eurjpc/zwac153 [doi]
AB  - AIMS: To compare the cardiac function and pulmonary vascular function during 
      exercise between dyspnoeic and non-dyspnoeic patients with Type 2 diabetes 
      mellitus (T2DM). METHODS AND RESULTS: Forty-seven T2DM patients with unexplained 
      dyspnoea and 50 asymptomatic T2DM patients underwent exercise echocardiography 
      combined with ergospirometry. Left ventricular (LV) function [stroke volume, 
      cardiac output (CO), LV ejection fraction, systolic annular velocity (s')], 
      estimated LV filling pressures (E/e'), mean pulmonary arterial pressures (mPAPs) 
      and mPAP/COslope were assessed at rest, low- and high-intensity exercise with 
      colloid contrast. Groups had similar patient characteristics, glycemic control, 
      stroke volume, CO, LV ejection fraction, and E/e' (P > 0.05). The dyspnoeic group 
      had significantly lower systolic LV reserve at peak exercise (s') (P = 0.021) 
      with a significant interaction effect (P < 0.001). The dyspnoeic group also had 
      significantly higher mPAP and mPAP/CO at rest and exercise (P < 0.001) with 
      significant interaction for mPAP (P < 0.009) and insignificant for mPAP/CO (P = 
      0.385). There was no significant difference in mPAP/COslope between groups (P = 
      0.706). However, about 61% of dyspnoeic vs. 30% of non-dyspnoeic group had 
      mPAP/COslope > 3 (P = 0.009). The mPAP/COslope negatively predicted V̇O2peak in 
      dyspneic group (beta = -1.86, 95% CI: -2.75, -0.98; multivariate model R2:0.54). 
      CONCLUSION: Pulmonary hypertension and less LV systolic reserve detected by 
      exercise echocardiography with colloid contrast underlie unexplained exertional 
      dyspnoea and reduced exercise capacity in T2DM.
CI  - (c) The Author(s) 2022. Published by Oxford University Press on behalf of the 
      European Society of Cardiology. All rights reserved. For permissions, please 
      email: journals.permissions@oup.com.
FAU - Gojevic, Tin
AU  - Gojevic T
AUID- ORCID: 0000-0002-2893-8629
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, 3500 Diepenbeek, Belgium.
FAU - Van Ryckeghem, Lisa
AU  - Van Ryckeghem L
AUID- ORCID: 0000-0003-3722-0034
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, 3500 Diepenbeek, Belgium.
FAU - Jogani, Siddharth
AU  - Jogani S
AUID- ORCID: 0000-0003-3760-197X
AD  - Jessa Hospital, Heart Centre Hasselt, 3500 Hasselt, Belgium.
FAU - Frederix, Ines
AU  - Frederix I
AUID- ORCID: 0000-0001-8636-5972
AD  - Department of Cardiology, Zuyderland MC, 6419 PC Heerlen, The Netherlands.
AD  - Faculty of Medicine and Health Sciences, Antwerp University, 2610 WILRIJK 
      (Antwerpen), Belgium.
FAU - Bakelants, Elise
AU  - Bakelants E
AUID- ORCID: 0000-0002-0824-0506
AD  - Jessa Hospital, Heart Centre Hasselt, 3500 Hasselt, Belgium.
AD  - Department of Cardiology, Geneva University Hospital, 1205 Geneve, Switzerland.
FAU - Petit, Thibault
AU  - Petit T
AUID- ORCID: 0000-0002-7720-8438
AD  - Jessa Hospital, Heart Centre Hasselt, 3500 Hasselt, Belgium.
FAU - Stroobants, Sarah
AU  - Stroobants S
AD  - Jessa Hospital, Heart Centre Hasselt, 3500 Hasselt, Belgium.
FAU - Dendale, Paul
AU  - Dendale P
AUID- ORCID: 0000-0003-0821-4559
AD  - BIOMED - Biomedical Research Centre, Faculty of Medicine and Life Sciences, 
      Hasselt University, 3500 Diepenbeek, Belgium.
AD  - Jessa Hospital, Heart Centre Hasselt, 3500 Hasselt, Belgium.
AD  - Faculty of Medicine and Life Sciences, Hasselt University, 3500 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, 3500 Diepenbeek, Belgium.
FAU - Herbots, Lieven
AU  - Herbots L
AUID- ORCID: 0000-0001-7784-3610
AD  - Jessa Hospital, Heart Centre Hasselt, 3500 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, 3500 Diepenbeek, Belgium.
AD  - Jessa Hospital, Heart Centre Hasselt, 3500 Hasselt, Belgium.
AD  - Faculty of Medicine and Life Sciences, Hasselt University, 3500 Hasselt, Belgium.
FAU - Verwerft, Jan
AU  - Verwerft J
AUID- ORCID: 0000-0003-2697-0825
AD  - Jessa Hospital, Heart Centre Hasselt, 3500 Hasselt, Belgium.
AD  - Faculty of Medicine and Life Sciences, Hasselt University, 3500 Hasselt, Belgium.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Eur J Prev Cardiol
JT  - European journal of preventive cardiology
JID - 101564430
SB  - IM
CIN - Eur J Prev Cardiol. 2023 Jan 24;30(2):123-124. PMID: 35959738
MH  - Humans
MH  - *Hypertension, Pulmonary/diagnostic imaging/etiology
MH  - *Diabetes Mellitus, Type 2/complications/diagnosis
MH  - Ventricular Function, Left
MH  - Stroke Volume
MH  - Exercise Test/methods
MH  - Dyspnea/diagnosis/etiology
MH  - *Ventricular Dysfunction, Left/diagnostic imaging/etiology
OTO - NOTNLM
OT  - Diabetes
OT  - Echocardiography
OT  - Heart
OT  - Pulmonary arterial pressure
OT  - Shortness of breath
COIS- Conflict of interest: None declared.
EDAT- 2022/07/27 06:00
MHDA- 2023/01/14 06:00
CRDT- 2022/07/26 14:04
PHST- 2022/05/12 00:00 [received]
PHST- 2022/07/16 00:00 [revised]
PHST- 2022/07/21 00:00 [accepted]
PHST- 2022/07/27 06:00 [pubmed]
PHST- 2023/01/14 06:00 [medline]
PHST- 2022/07/26 14:04 [entrez]
AID - 6650274 [pii]
AID - 10.1093/eurjpc/zwac153 [doi]
PST - ppublish
SO  - Eur J Prev Cardiol. 2023 Jan 11;30(1):37-45. doi: 10.1093/eurjpc/zwac153.