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Association of Exercise Intolerance in Type 2 Diabetes With Skeletal Muscle Blood Flow Reserve.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Sacre, Julian W. Jellis, Christine L. Haluska, Brian A. Jenkins, Carly Coombes, Jeff S. Marwick, Thomas H. Keske, Michelle A.
Description	Country affiliation: Australia Author Affiliation: Sacre JW ( School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia); Jellis CL ( School of Medicine, University of Queensland, Brisbane, Australia.); Haluska BA ( School of Medicine, University of Queensland, Brisbane, Australia.); Jenkins C ( School of Medicine, University of Queensland, Brisbane, Australia.); Coombes JS ( School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia.); Marwick TH ( School of Medicine, University of Queensland, Brisbane, Australia); Keske MA ( Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia.)
Abstract	OBJECTIVES: This study sought to investigate the association of exercise intolerance in type 2 diabetes (T2DM) with skeletal muscle capillary blood flow (CBF) reserve. BACKGROUND: Exercise intolerance in T2DM strongly predicts adverse prognosis, but associations with muscle blood flow independent of cardiac dysfunction are undefined. METHODS: In 134 T2DM patients without cardiovascular disease, left ventricular function and contrast-enhanced ultrasound of the quadriceps (for CBF; i.e., product of capillary blood volume and velocity) were assessed at rest and immediately following treadmill exercise for peak oxygen uptake (Vo2peak). Left ventricular systolic and diastolic functional reserve indexes were derived from changes in systolic and early diastolic color tissue Doppler velocities. Cardiac index reserve and its constituents (stroke volume and chronotropic indexes) and left ventricular filling pressure (ratio of early diastolic mitral inflow and annular velocities) were also measured. RESULTS: Vo2peak correlated with muscle CBF reserve (ß = 0.16, p = 0.005) independent of cardiac index reserve and clinical covariates. This was explained by higher muscle capillary blood velocity reserve (ß = 0.18, p = 0.002), rather than blood volume reserve (p > 0.10) in patients with higher Vo2peak. A concurrent association of Vo2peak with cardiac index reserve (ß = 0.20, p < 0.001) appeared to reflect chronotropic index (ß = 0.15, p = 0.012) rather than stroke volume index reserve (p > 0.10), although the systolic functional reserve index was also identified as an independent correlate (ß = 0.16, p = 0.028). No associations of Vo2peak with diastolic functional reserve were identified (p > 0.10). CONCLUSIONS: Vo2peak is associated with muscle CBF reserve in T2DM, independent of parallel associations with cardiac functional reserve. This is consistent with a multifactorial basis for exercise intolerance in T2DM.
File Format	HTM / HTML
ISSN	1936878X
Issue Number	8
Volume Number	8
e-ISSN	18767591
Journal	JACC: Cardiovascular Imaging
Language	English
Publisher	Elsevier
Publisher Date	2015-08-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Diagnostic Imaging Discipline Cardiology Diabetes Mellitus, Type 2 Physiopathology Exercise Tolerance Physiology Muscle, Skeletal Blood Supply Diastole Echocardiography Exercise Test Female Humans Male Middle Aged Systole Ventricular Function, Left Journal Article Research Support, N.i.h., Extramural
Content Type	Text
Resource Type	Article
Subject	Radiology, Nuclear Medicine and Imaging Cardiology and Cardiovascular Medicine

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1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
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3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
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Mikrovasküler komplikasyonu olmayan tip II diabetes mellituslu hastalarda bölgesel sol ventrikül fonksiyonlarinin gerilim (strain) ve gerilim hizi (strain rate) ekokardiyografi ile degerlendirilmesi.

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Association of Exercise Intolerance in Type 2 Diabetes With Skeletal Muscle Blood Flow Reserve.

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Mikrovasküler komplikasyonu olmayan tip II diabetes mellituslu hastalarda bölgesel sol ventrikül fonksiyonlarinin gerilim (strain) ve gerilim hizi (strain rate) ekokardiyografi ile degerlendirilmesi.

Prognostic implications of left ventricular filling pressure with exercise.

Association of Exercise Intolerance in Type 2 Diabetes With Skeletal Muscle Blood Flow Reserve.