Endothelial function and left ventricular diastolic functional reserve in type 2 diabetes mellitus
Melissa Leung1, Victoria Phan1, Dominic Y Leung1
1Department of Cardiology , Liverpool Hospital, University of New South Wales , Sydney , Australia.
Open Heart
|October 22, 2014
Summary
Patients with diabetes mellitus exhibit impaired endothelial function and reduced left ventricular (LV) diastolic reserve. Improving endothelial function may enhance LV diastolic reserve and exercise capacity in these individuals.
Area of Science:
- Cardiovascular Medicine
- Endocrinology
- Vascular Biology
Background:
- Endothelial dysfunction is an early indicator of vascular disease.
- Left ventricular (LV) diastolic reserve, crucial for augmenting diastolic function during exercise, may be compromised in patients with diabetes mellitus (DM).
- The relationship between endothelial dysfunction, impaired LV diastolic reserve, and reduced exercise capacity in DM remains unclear.
Purpose of the Study:
- To investigate the association between endothelial dysfunction and impaired LV diastolic reserve in patients with type 2 DM.
- To determine if endothelial function correlates with exercise capacity in this patient population.
Main Methods:
- Ninety-six patients with type 2 DM and 10 controls underwent brachial artery reactivity testing and exercise echocardiography.
- Measurements included flow-mediated dilation (FMD), rest and exercise LV diastolic function parameters (e', Δe', diastolic reserve index), and exercise capacity (METs).
- Statistical analyses explored correlations and independent predictors of LV diastolic reserve and exercise capacity.
Main Results:
- Patients with DM demonstrated significantly lower LV diastolic reserve (Δe', diastolic reserve index) and reduced FMD compared to controls.
- FMD was strongly correlated with measures of LV diastolic reserve and was an independent predictor of these parameters.
- FMD, younger age, male gender, lower BMI, and lower rest E/e' were independent predictors of higher exercise capacity (METs).
Conclusions:
- Type 2 DM is associated with impaired endothelial function and LV diastolic dysfunction.
- LV diastolic reserve and exercise capacity are significantly linked to endothelial function in patients with DM.
- Interventions targeting vascular risk factors to improve endothelial function hold potential for enhancing LV diastolic reserve and exercise capacity.
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