Role of Exercise Stress Echocardiography in the Detection of Subclinical Diastolic Dysfunction in Asymptomatic Diabetics

Document Type : Original Article

Authors

Cardiology Department, Faculty of Medicine, Suez Canal University, Egypt

Abstract

Background:Subclinical left ventricular dysfunction is not uncommon and is a predictor of heart failure. Diabetes commonly presents with exertional dyspnea and reduced exercise tolerance, which is due to diastolic dysfunction. Diastolic exercise echocardiography is a relatively novel modality to detect latent diastolic dysfunction. Aim: We aimed to evaluate the different parameters that affect raised filling pressure during exercise in asymptomatic diabetics using exercise stress echocardiography. Subjects and Methods:This is a case-control study that included 70 persons (35 diabetics and 35 normal volunteers age and sex-matched) who had exertional dyspnea but were asymptomatic at rest. They had a normal systolic and diastolic functions at rest. They did treadmill exercise stress ECG. Post-peak stress images were obtained as quickly as possible after the patient transferred from the treadmill to the imaging table measuring the E/e' ratio. Results:Filling pressure raised dramatically in the diabetic group compared to non-diabetics. Using linear regression analysis, HbA1c as a continuous variable, duration of DM, and waist circumference showed a positive linear significant association with E/e’ during exercise. Conclusion:HbA1c level, duration of DM, waist circumference, and eGFR are related to subclinical diastolic dysfunction in asymptomatic diabetics during exercise.
 

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