PMID- 37118820
OWN - NLM
STAT- MEDLINE
DCOM- 20230501
LR  - 20230522
IS  - 1475-2840 (Electronic)
IS  - 1475-2840 (Linking)
VI  - 22
IP  - 1
DP  - 2023 Apr 28
TI  - Association of complication of type 2 diabetes mellitus with hemodynamics and 
      exercise capacity in patients with heart failure with preserved ejection 
      fraction: a case-control study in individuals aged 65-80 years.
PG  - 97
LID - 10.1186/s12933-023-01835-2 [doi]
LID - 97
AB  - BACKGROUND: Type 2 diabetes mellitus (T2DM) is a frequently observed complication 
      in patients with heart failure with preserved ejection fraction (HFpEF). Although 
      a characteristic finding in such patients is a decrease in objective exercise 
      capacity represented by peak oxygen uptake (peakVO(2)), exercise capacity and its 
      predictors in HFpEF with T2DM remain not clearly understood. This case-control 
      study aimed to investigate the association between exercise capacity and 
      hemodynamics indicators and T2DM comorbidity in patients with HFpEF aged 
      65-80 years. METHODS: Ninety-nine stable outpatients with HFpEF and 50 
      age-and-sex-matched controls were enrolled. Patients with HFpEF were classified 
      as HFpEF with T2DM (n = 51, median age, 76 years) or without T2DM (n = 48, median 
      age, 76 years). The peakVO(2) and ventilatory equivalent versus carbon dioxide 
      output slope (VE vs VCO(2) slope) were measured by cardiopulmonary exercise 
      testing. The peak heart rate (HR) and peak stroke volume index (SI) were measured 
      using impedance cardiography, and the estimated arteriovenous oxygen difference 
      (peak a-vO(2) diff) was calculated with Fick's equation. The obtained data were 
      compared among the three groups using analysis of covariance adjusted for the 
      beta-blocker medication, presence or absence of sarcopenia, and hemoglobin levels in 
      order to determine the T2DM effects on exercise capacity and hemodynamics in 
      patients with HFpEF. RESULTS: In HFpEF with T2DM compared with HFpEF without T2DM 
      and the controls, the prevalence of sarcopenia, chronotropic incompetence, and 
      anemia were significantly higher (p < 0.001). The peakVO(2) (Controls 23.5 vs. 
      without T2DM 15.1 vs. with T2DM 11.6 mL/min/kg), peak HR (Controls 164 vs. 
      without T2DM 132 vs. with T2DM 120 bpm/min), peak a-vO(2) (Controls 13.1 vs 
      without T2DM 10.6 vs with T2DM 8.9 mL/100 mL), and VE vs VCO(2) slope (Controls 
      33.2 vs without T2DM 35.0 vs with T2DM 38.2) were significantly worsened in 
      patients with HFpEF with T2DM (median, p < 0.001). There was no significant 
      difference in peak SI among the three groups. CONCLUSIONS: Our results suggested 
      that comorbid T2DM in patients with HFpEF may reduce exercise capacity, HR 
      response, peripheral oxygen extraction, and ventilation efficiency. These results 
      may help identify cardiovascular phenotypes of HFpEF complicated with T2DM and 
      intervention targets for improving exercise intolerance.
CI  - (c) 2023. The Author(s).
FAU - Sugita, Yousuke
AU  - Sugita Y
AD  - Faculty of Health Sciences, Tsukuba University of Technology, 4-12-7, Kasuga, 
      Tsukuba, Ibaraki, 305-8521, Japan. y.sugita@cc.k.tsukuba-tech.ac.jp.
FAU - Ito, Katsuhiko
AU  - Ito K
AD  - Department of Rehabilitation, National Hospital Organization Matsumoto National 
      Hospital, Matsumoto, Japan.
FAU - Yoshioka, Yui
AU  - Yoshioka Y
AD  - Department of Rehabilitation, Musashino General Hospital, Kawagoe, Japan.
FAU - Sakai, Satoshi
AU  - Sakai S
AD  - Faculty of Health Sciences, Tsukuba University of Technology, 4-12-7, Kasuga, 
      Tsukuba, Ibaraki, 305-8521, Japan.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20230428
PL  - England
TA  - Cardiovasc Diabetol
JT  - Cardiovascular diabetology
JID - 101147637
RN  - S88TT14065 (Oxygen)
RN  - Diabetes Mellitus, Noninsulin-Dependent, 1
RN  - Diabetes Mellitus, Noninsulin-Dependent, 2
SB  - IM
MH  - Humans
MH  - *Heart Failure/diagnosis/epidemiology
MH  - Stroke Volume/physiology
MH  - Case-Control Studies
MH  - Exercise Tolerance/physiology
MH  - *Diabetes Mellitus, Type 2/diagnosis/epidemiology
MH  - *Sarcopenia
MH  - Hemodynamics
MH  - Exercise Test/methods
MH  - Oxygen
PMC - PMC10148403
OTO - NOTNLM
OT  - Anemia
OT  - Echocardiography
OT  - Heart failure with preserved ejection fraction
OT  - Peak arteriovenous oxygen difference
OT  - Peak heart rate
OT  - Peak oxygen uptake
OT  - Peak stroke volume
OT  - Sarcopenia
OT  - Type 2 diabetes mellitus
OT  - Ventilatory equivalent versus carbon dioxide output slope
COIS- The authors declare that they have no competing interests.
EDAT- 2023/04/29 19:42
MHDA- 2023/05/01 06:42
PMCR- 2023/04/28
CRDT- 2023/04/29 00:02
PHST- 2023/02/01 00:00 [received]
PHST- 2023/04/15 00:00 [accepted]
PHST- 2023/05/01 06:42 [medline]
PHST- 2023/04/29 19:42 [pubmed]
PHST- 2023/04/29 00:02 [entrez]
PHST- 2023/04/28 00:00 [pmc-release]
AID - 10.1186/s12933-023-01835-2 [pii]
AID - 1835 [pii]
AID - 10.1186/s12933-023-01835-2 [doi]
PST - epublish
SO  - Cardiovasc Diabetol. 2023 Apr 28;22(1):97. doi: 10.1186/s12933-023-01835-2.