Abstract
1828 Left ventricular diastolic dysfunction (LVDD) may be the first manifestation of diabetic cardiomyopathy. This could explain impaired peak exercise performance attained in subjects with type 2 diabetes in exercise training studies. Men with type 2 diabetes were separated into 2 groups (n=16/group) on the basis of LVDD 1) absence or 2) presence. They were matched for age and were without evidence of hypertension, gross proteinuria, coronary artery disease, congestive heart failure and thyroid disease. Subjects did not use any cardiovascular medications and were sedentary during the preceding year. Diastolic function was evaluated with echocardiographic standard criteria. Resting systolic function was normal in all subjects. Each performed a symptom-limited modified Bruce protocol treadmill exercise test. Maximal treadmill performance was higher in subjects with normal diastolic function compared to subjects with LVDD (11.6 ± 0.5 vs 10.0 ± 0.6 METs respectively, means ± SE, p<0.05). There were no significant differences in maximal heart rate, and maximal systolic or diastolic blood pressure. In conclusion, this study demonstrated that LVDD influences maximal treadmill performance. This suggests that in this well-characterized cohort of men with type 2 diabetes and without detectable heart disease, impaired left ventricular diastolic dysfunction could explain lower maximal performance found in this high-risk population.
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