Cardiovascular determinants of aerobic exercise capacity in adults with type 2 diabetes
Year: 2020
Type: other
Abstract: Objective To assess the relationship between subclinical cardiac dysfunction and aerobic exercise capacity (peak VO2) in adults with type 2 diabetes (T2D), a group at high risk of developing heart failure. Research design and methods Cross-sectional study. We prospectively enrolled a multi-ethnic cohort of asymptomatic adults with T2D and no history, signs or symptoms of cardiovascular disease. Age-, sex-, and ethnicity-matched controls were recruited for comparison. Participants underwent bio-anthropometric profiling, cardiopulmonary exercise testing and cardiovascular magnetic resonance with adenosine stress perfusion imaging. Multivariable linear regression analysis was undertaken to identify independent associations between measures of cardiovascular structure and function and peak VO2. Results Two hundred and forty seven adults with T2D (age 51.8±11.9 years, 55% males, 37% black or south Asian ethnicity, HbA1c 7.4±1.1% (57±12 mmol/mol), duration of diabetes 61 (32 – 120) months and 78 controls were included. Subjects with T2D had increased concentric left ventricular (LV) remodelling, reduced myocardial perfusion reserve, and markedly lower aerobic exercise capacity (peak VO2 18.0±6.6 vs. 27.8±9.0mL/kg/min, p<0.001) compared with controls. In a multivariable linear regression model containing age, sex, ethnicity, smoking status and systolic blood pressure, only myocardial perfusion reserve (β=0.822, p=0.006) and E/e’ (β= -0.388, p=0.001) were independently associated with peak VO2 in subjects with T2D. Conclusions In a multi-ethnic cohort of asymptomatic people with T2D, myocardial perfusion reserve and diastolic function are key determinants of aerobic exercise capacity, independent of age, sex, ethnicity, smoking status, or blood pressure.
Language: English
Subfield: Complementary and alternative medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W4251858364