Exercise Capacity and Diastolic Function in Patients after Coronary Surgery: Comparison between diabetes and non-diabetes
Date Issued
2005
Date
2005
Author(s)
Hsu, Ching-Ling
DOI
zh-TW
Abstract
Background and Purpose: The influencing factors of exercise capacity in patients after coronary artery bypass grafting (CABG), especially those with type 2 diabetes, have not been fully explored. Previous studies have demonstrated that left ventricular (LV) diastolic function correlated with exercise capacity. The purpose of this study was (1) to compare the peak exercise capacity and LV diastolic function between patients with and without diabetes and (2) to investigate the interrelations among peak oxygen consumption (VO2peak), LV diastolic function, blood sugar, and lipid profile. Methods: Fifty-one patients who underwent their first CABG more than 3 months were recruited. Those who had heart failure, valvular disease, myocardial infarction, abnormal kidney or liver function, or other systemic or acute illness that might impede the exercise testing were excluded. Twenty-three subjects were diabetes and 28 were non-diabetes. All subjects took echocardiography and impedance cardiography, graded maximal exercise test, and biochemical analyses of sugar and lipids. Nonparametric independent t-test (Mann-Whitney U test) andχ2 test were used to compare the differences between groups. The relationships between LV diastolic function, exercise capacity, and biochemical data were analyzed by Pearson product-moment correlation. A p value less than 0.05 was considered statistically significant. Results: Subjects in two groups were comparable in demographic data. Diabetic patients had lower values in early peak filling velocity (E’), peak atrial filling velocity (A’), and VO2peak (p = 0.005, p = 0.003, p<0.0005), and higher values in LV filling pressure (E/E’) (p = 0.004) than the non-diabetes. No significant difference was found in stroke volume (p > 0.05) between groups. In the results of correlation analysis, peak atrial filling flow velocity (A) and E/E’ were negatively correlated with VO2peak after age adjustments (r = -0.336, p = 0.024). Glycated hemoglobin, and triglyceride were also significantly correlated with VO2peak (r = -0.377 and r = -0.307, respectively). Only high-density lipoprotein cholesterol had significant correlation with some of LV diastolic indices. Conclusion: Diabetic patients after CABG had lower values in LV myocardial compliance and atrial compensatory filling capacity and higher values in LV filling pressure than those non-diabetic patients. The negative relationship between exercise capacity and elevated LV filling pressure was also demonstrated.
Subjects
運動能力
左心室舒張功能
冠狀動脈繞道手術
糖尿病
Exercise capacity
Left ventricular diastolic function
Coronary surgery
Diabetes
SDGs
Type
other
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