title: Impact of diabetes and diastolic dysfunction on exercise capacity in normotensive patients without coronary artery disease.
abstract: OBJECTIVE
  The aim of this study was to determine the impact of diabetes and diastolic dysfunction on exercise capacity in asymptomatic, normotensive patients with type 2 diabetes without coronary artery disease.
  
  
  METHODS
  A total of 43 type 2 diabetes patients (age: 50 ± 5 years) and 20 healthy controls (age: 48 ± 4 years) were enrolled. Diastolic function was investigated by conventional pulsed-wave (PW) Doppler and tissue Doppler imaging (TDI). Exercise capacity was evaluated with cardiopulmonary exercise testing (CPET).
  
  
  RESULTS
  In patients with type 2 diabetes, increase in resting heart rate (HR-rest) (p = 0.013), decrease in maximum heart rate during exercise (HR-max) (p < 0.001) and exercise time (p < 0.001) compared with controls were significant. Patients had significantly increased minute ventilation volume (VE)/maximum carbon dioxide discharge (VCO2) ratio (p < 0.001), decreased maximum oxygen consumption (VO2-max) (p < 0.001), oxygen consumption at anaerobic threshold (VO2-an) (p < 0.001) and maximum carbon dioxide discharge (VCO2) (p < 0.001) compared to controls indicating significantly reduced exercise capacity. HbA1c was inversely correlated with VO2-max (r = -0.456, p < 0.01) independent of the absence or presence of mild diastolic dysfunction.
  
  
  CONCLUSIONS
  Exercise capacity was found to be significantly decreased in normotensive patients with type 2 diabetes without coronary artery disease, and this decrease was independent of diastolic dysfunction.
authors: Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey gurdal27@hotmail.com.
authors: Ahmet
authors: A
authors: Gürdal
authors: Department of Sports Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors: Erdem
authors: E
authors: Kasikcioglu
authors: Department of Sports Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors: Sertac
authors: S
authors: Yakal
authors: Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors: Zehra
authors: Z
authors: Bugra
mesh_terms: D000328:Adult; D058070:Asymptomatic Diseases; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D058065:Diabetic Cardiomyopathies / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D003971:Diastole; D015150:Echocardiography, Doppler; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D012123:Pulmonary Ventilation; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D016277:Ventricular Function, Left
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: Type 2 diabetes; cardiopulmonary exercise test; diastolic dysfunction; exercise capacity