PMID- 37928757 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231107 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 10 DP - 2023 TI - Abnormal left ventricular systolic reserve function detected by treadmill exercise stress echocardiography in asymptomatic type 2 diabetes. PG - 1253440 LID - 10.3389/fcvm.2023.1253440 [doi] LID - 1253440 AB - AIMS: Subclinical left ventricular (LV) dysfunction may occur in T2DM patients at the early asymptomatic stage, and LV reserve function is a sensitive index to detect subtle LV dysfunction. The purpose of our study is (1) to assess the LV reserve function using treadmill exercise stress echocardiography (ESE) in asymptomatic type 2 diabetes mellitus (T2DM) patients; (2) to explore the link of serum biological parameters and LV reserve function. METHODS: This study included 84 patients with asymptomatic T2DM from September 2021 to July 2022 and 41 sex- and age-matched healthy controls during the corresponding period. All subjects completed treadmill ESE, LV systolic function-related parameters such as global longitudinal strain (GLS) and systolic strain rate (SRs), as well as diastolic function-related parameters such as E wave (E), early diastolic velocity (e'), E/e' ratio, early diastolic SR (SRe), and late diastolic SR (SRa) were compared at rest and immediately after exercise. The difference between LV functional parameters after treadmill exercise and its corresponding resting value was used to compute LV reserve function. In addition, the associations of LV reserve function and serum biological parameters were analyzed. RESULTS: Patients with T2DM did not significantly vary from the controls in terms of alterations in LV diastolic reserve measures, the changes of LVGLS and SRs (DeltaGLS: 2.19 +/- 2.72% vs. 4.13 +/- 2.79%, P < 0.001 and DeltaSRs:0.78 +/- 0.33 s(-1) vs. 1.02 +/- 0.28 s(-1), P < 0.001) in the T2DM group were both lower than those in the control group. Glycated hemoglobin (HbA1c), N-terminal pro-brain natriuretic peptide (NTproBNP), waist circumference, and high-sensitive C-reactive protein (hsCRP) were identified as independent predictors of LV systolic reserve by stepwise multiple linear regression analysis. CONCLUSION: LV systolic reserve function, as measured by pre- and post-exercise differences in GLS and SRs were significantly impaired in patients with asymptomatic T2DM, whereas diastolic reserve remained normal during exercise and was comparable to that of the control group. This was different from previous findings. High levels of HbA1c, NTproBNP, hsCRP, and increasing waist circumference were independent predictors of LV systolic reserve. CI - (c) 2023 Duan, Ye, Shu, Huang, Zhang, Zhang, Ding, Deng, Li, Yin and Wang. FAU - Duan, Yuyou AU - Duan Y AD - School of Clinical Medicine, Southwest Medical University, Luzhou, China. FAU - Ye, Luwei AU - Ye L AD - Ultrasound in Cardiac Electrophysiology and Biomechanics Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China. FAU - Shu, Qinglan AU - Shu Q AD - Ultrasound in Cardiac Electrophysiology and Biomechanics Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China. FAU - Huang, Yu AU - Huang Y AD - Ultrasound in Cardiac Electrophysiology and Biomechanics Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China. FAU - Zhang, Hongmei AU - Zhang H AD - Ultrasound in Cardiac Electrophysiology and Biomechanics Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China. FAU - Zhang, Qingfeng AU - Zhang Q AD - Ultrasound in Cardiac Electrophysiology and Biomechanics Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China. FAU - Ding, Geqi AU - Ding G AD - Ultrasound in Cardiac Electrophysiology and Biomechanics Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China. FAU - Deng, Yan AU - Deng Y AD - Ultrasound in Cardiac Electrophysiology and Biomechanics Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China. FAU - Li, Chunmei AU - Li C AD - Ultrasound in Cardiac Electrophysiology and Biomechanics Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China. FAU - Yin, Lixue AU - Yin L AD - Ultrasound in Cardiac Electrophysiology and Biomechanics Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China. FAU - Wang, Yi AU - Wang Y AD - School of Clinical Medicine, Southwest Medical University, Luzhou, China. AD - Ultrasound in Cardiac Electrophysiology and Biomechanics Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China. LA - eng PT - Journal Article DEP - 20231019 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC10622805 OTO - NOTNLM OT - asymptomatic type 2 diabetes mellitus OT - left ventricular reserve function OT - serum biological parameters OT - treadmill exercise stress echocardiography OT - two-dimensional speckle-tracking imaging COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2023/11/06 06:42 MHDA- 2023/11/06 06:43 PMCR- 2023/01/01 CRDT- 2023/11/06 04:40 PHST- 2023/07/05 00:00 [received] PHST- 2023/10/09 00:00 [accepted] PHST- 2023/11/06 06:43 [medline] PHST- 2023/11/06 06:42 [pubmed] PHST- 2023/11/06 04:40 [entrez] PHST- 2023/01/01 00:00 [pmc-release] AID - 10.3389/fcvm.2023.1253440 [doi] PST - epublish SO - Front Cardiovasc Med. 2023 Oct 19;10:1253440. doi: 10.3389/fcvm.2023.1253440. eCollection 2023.