High E/e' disrupts the rapid lowering of blood glucose in response to exercise training

No relationship between the ratio of peak early velocity of left ventricular inflow to peak systolic longitudinal velocity of the mitral annulus velocity (E/e') and insulin resistance has yet been shown in patients with cardiac disease. We hypothesized that patients with high E/e' values would tend not to show the rapid blood glucose-lowering in response to exercise training characteristic of impaired glucose tolerance (IGT) or diabetes mellitus (DM) patients.

The subjects were continuous IGT/DM patients (n = 27) participating in cardiac rehabilitation. All patients' E/e' values were measured by echocardiography. The patients' blood glucose levels (mg/dl) were measured just before (pre-BS) and after (post-BS) exercise training. Post-BS was subtracted from pre-BS to obtain ΔBS, and the relationship between E/e' and ΔBS was investigated.

E/e' correlated negatively with ΔBS. Moreover, E/e' was a significant predictor of ΔBS and as such was independent of hemoglobin A1c (HbA1c), pre-BS, and presence of atrial fibrillation on multivariate analysis.

Patients with high E/e', indicating high left ventricular filling pressure, were unlikely to exhibit the rapid glucose-lowering response.