title: Assessing the Value of BMI and Aerobic Capacity as Surrogate Markers for the Severity of Left Ventricular Diastolic Dysfunction in Patients with Type 2 Diabetes Who Are Obese.
abstract: Left ventricular diastolic dysfunction (LVDD) is one of the earliest signs for abnormal cardiac function in patients with type 2 diabetes (T2DM). It is important to explore the risk factors that will assist in identifying the severity of the LVDD in this population. We examined the influences of fitness and fatness on the level of left ventricular (LV) impairment in patients with T2DM. Twenty-five patients (age: 64.0 ± 2.5 years, body mass index [BMI] = 36.0 ± 1.5 kg/m(2), mean ± standard error of measurement) with T2DM and preserved systolic function, but impaired diastolic function, mitral valve (MV) E/e', participated in the study. LV function was assessed using a stress echocardiograph, aerobic power was assessed with a sign- and symptom-limited graded exercise test, and the fatness level was assessed using Dual-energy X-ray absorptiometry and BMI. Patients in the higher 50% of BMI had higher lateral and septal MV E/e' (∼34% and ∼25%, respectively, both P < 0.001), compared to those in the lower 50% of BMI, with no difference in LV ejection fraction (LVEF) (P > 0.05). In addition, a higher BMI correlated with a higher lateral (r = 0.62, P < 0.001) and septal (r = 0.56, P < 0.01) E/e'. There was no such relationship for VO2peak. BMI and VO2peak were not correlated with LV systolic function (ejection fraction). In individuals with T2DM and diastolic dysfunction, a higher BMI was associated with worsening diastolic function independent of their aerobic capacity. The data provide a simple and practical approach for clinicians to assist in the early identification and diagnostics of functional changes in the heart diastolic function in this population.
authors.affiliation: Clinical Exercise Science Research Program, Institute of Sport, Exercise and Active Living (ISEAL), Victoria University, Melbourne, VIC, Australia.
authors.forename: Cassandra
authors.initials: C
authors.lastname: Smith
authors.affiliation: University of Melbourne and the Department of Cardiology, Austin Health, Melbourne Australia.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Asrar Ul Haq
authors.affiliation: University of Melbourne and the Department of Endocrinology, Austin Health, Melbourne, Australia.
authors.forename: George
authors.initials: G
authors.lastname: Jerums
authors.affiliation: Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, NC, USA.
authors.forename: Erik
authors.initials: E
authors.lastname: Hanson
authors.affiliation: Clinical Exercise Science Research Program, Institute of Sport, Exercise and Active Living (ISEAL), Victoria University, Melbourne, VIC, Australia.; Centre for Chronic Disease, College of Health and Biomedicine, Victoria University, Melbourne, VIC, Australia.
authors.forename: Alan
authors.initials: A
authors.lastname: Hayes
authors.affiliation: Clinical Exercise Science Research Program, Institute of Sport, Exercise and Active Living (ISEAL), Victoria University, Melbourne, VIC, Australia.
authors.forename: Jason D
authors.initials: JD
authors.lastname: Allen
authors.affiliation: Clinical Exercise Science Research Program, Institute of Sport, Exercise and Active Living (ISEAL), Victoria University, Melbourne, VIC, Australia.
authors.forename: Melissa
authors.initials: M
authors.lastname: Sbaraglia
authors.affiliation: School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia.
authors.forename: Steve
authors.initials: S
authors.lastname: Selig
authors.affiliation: University of Melbourne and Western Health, Melbourne, Australia.
authors.forename: Chiew
authors.initials: C
authors.lastname: Wong
authors.affiliation: University of Melbourne and the Department of Cardiology, Austin Health, Melbourne Australia.
authors.forename: David L
authors.initials: DL
authors.lastname: Hare
authors.affiliation: Clinical Exercise Science Research Program, Institute of Sport, Exercise and Active Living (ISEAL), Victoria University, Melbourne, VIC, Australia.; University of Melbourne and the Department of Cardiology, Austin Health, Melbourne Australia.
authors.forename: Itamar
authors.initials: I
authors.lastname: Levinger
keywords: aerobic capacity; body mass index; left ventricular diastolic dysfunction; type 2 diabetes