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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.
Austin Authors: Smith, Cassandra;Asrar Ul Haq, Muhammad;Jerums, George ;Hanson, Erik;Hayes, Alan;Allen, Jason D;Sbaraglia, Melissa;Selig, Steve;Wong, Chiew;Hare, David L ;Levinger, Itamar 
Affiliation: University of Melbourne, Melbourne Australia
Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia
Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, NC, USA
Centre for Chronic Disease, College of Health and Biomedicine, Victoria University, Melbourne, Victoria, Australia
Clinical Exercise Science Research Program, Institute of Sport, Exercise and Active Living (ISEAL), Victoria University, Melbourne, Victoria, Australia
School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Victoria, Australia
Western Health, Melbourne, Australia
Department of Cardiology, Austin Health, Heidelberg, Victoria, Australia
Issue Date: 12-May-2016 2016
Publication information: Clinical Medicine Insights. Cardiology 2016; 10: 61-5
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.
DOI: 10.4137/CMC.S38116
ORCID: 0000-0001-9554-6556
PubMed URL: 27199576
ISSN: 1179-5468
Type: Journal Article
Subjects: aerobic capacity
body mass index
left ventricular diastolic dysfunction
type 2 diabetes
Appears in Collections:Journal articles

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