Association Between Functional Capacity And Left Ventricular Mechanics In Patients With Uncomplicated Type 2 Diabetes

Objective: We aimed to evaluate the functional capacity and left ventricular (LV) mechanics, as well as their relationship in the patients with uncomplicated type 2 diabetes. Design and method: This cross-sectional observational study included 70 controls and 60 patients with uncomplicated diabetes. Included subjects underwent laboratory analysis, cardiopulmonary exercise testing and comprehensive echocardiographic examination. Results: Oxygen uptake at ventilatory threshold (18.8 ± 3.8 vs. 14.8 ± 3.7 ml/kg/min, p < 0.001), peak oxygen uptake (peak VO2) (28.2 ± 4.2 vs. 19.8 ± 4.4, ml/kg/min, p < 0.001) and oxygen pulse (13.8 ± 2.9 vs. 11.3 ± 3.1 ml/beat, p < 0.001) were significantly lower in the diabetic group, whereas ventilation/carbon dioxide ratio and ventilation/carbon dioxide slope (25.0 ± 2.4 vs. 28.2 ± 3.7, p < 0.001) were significantly higher in this group. Longitudinal, circumferential and radial strains were significantly lower in the diabetic patients than in healthy controls (−21.6 ± 2.9 vs. −18.1 ± 2.2 %, p < 0.001; −22 ± 2.6 vs. −18.6 ± 2.7 %, p < 0.001; 39.4 ± 9.3 vs. 35.5 ± 8.8 %, p < 0.001, respectively). A multivariate regression analysis showed that HbA1c, mitral E/e ratio and peak VO2 were associated with LV longitudinal and circumferential strains independently of age, BMI, systolic blood pressure and LV mass index in the whole study population. Conclusions: Our investigation showed that both, functional capacity and LV mechanics were significantly impaired in the uncomplicated diabetic patients. HbA1c, the essential parameter of glucose regulation, LV diastolic function and oxygen consumption were independently associated with LV mechanics in the whole study population. This shows an important role of functional capacity as important markers of preclinical cardiac damage in diabetic population.