Type 2 diabetes is an independent predictor of lowered peak aerobic capacity in heart failure patients with non-reduced or reduced left ventricular ejection fraction

被引：15

作者：

Abe, Takahiro ^{[1
,2
]}

Yokota, Takashi ^{[1
,2
]}

Fukushima, Arata ^{[1
,2
]}

Kakutani, Naoya ^{[1
,2
]}

Katayama, Takashi ^{[1
,2
]}

Shirakawa, Ryosuke ^{[1
,2
]}

Maekawa, Satoshi ^{[1
,2
]}

Nambu, Hideo ^{[1
,2
]}

Obata, Yoshikuni ^{[1
,2
]}

Yamanashi, Katsuma ^{[1
,2
]}

Nakano, Ippei ^{[1
,2
]}

Takada, Shingo ^{[1
,2
]}

Yokota, Isao ^{[3
,4
]}

Okita, Koichi ^{[5
]}

Kinugawa, Shintaro ^{[1
,2
]}

Anzai, Toshihisa ^{[1
,2
]}

机构：

[1] Hokkaido Univ, Fac Med, Dept Cardiovasc Med, Kita Ku, Kita 15 Nishi 7, Sapporo, Hokkaido 0608638, Japan

[2] Hokkaido Univ, Grad Sch Med, Kita Ku, Kita 15 Nishi 7, Sapporo, Hokkaido 0608638, Japan

[3] Hokkaido Univ, Fac Med, Dept Biostat, Sapporo, Hokkaido, Japan

[4] Hokkaido Univ, Grad Sch Med, Sapporo, Hokkaido, Japan

[5] Hokusho Univ, Grad Sch Lifelong Sport, Ebetsu, Hokkaido, Japan

来源：

CARDIOVASCULAR DIABETOLOGY | 2020年 / 19卷 / 01期

基金：

日本科学技术振兴机构;

关键词：

Exercise; Heart failure; Oxygen uptake; Type; 2; diabetes; SKELETAL-MUSCLE METABOLISM; EXERCISE INTOLERANCE; ASSOCIATION; MELLITUS; MITOCHONDRIAL; FITNESS; STRESS; TRIAL;

D O I：

10.1186/s12933-020-01114-4

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background Although type 2 diabetes mellitus (T2DM) is one of the most frequent comorbidities in patients with chronic heart failure (CHF), the effects of T2DM on the exercise capacity of CHF patients are fully unknown. Here, we tested the hypothesis that the coexistence of T2DM lowers CHF patients' peak aerobic capacity. Methods We retrospectively analyzed the cases of 275 Japanese CHF patients with non-reduced ejection fraction (left ventricular ejection fraction [LVEF] >= 40%) or reduced EF (LVEF < 40%) who underwent cardiopulmonary exercise testing. We divided them into diabetic and nondiabetic groups in each CHF cohort. Results The mean peak oxygen uptake (VO2) value was 16.87 mL/kg/min in the non-reduced LVEF cohort and 15.52 mL/kg/min in the reduced LVEF cohort. The peak VO(2)was lower in the diabetics versus the nondiabetics in the non-reduced LVEF cohort with the mean difference (95% confidence interval [95% CI]) of - 0.93 (- 1.82 to - 0.04) mL/kg/min and in the reduced LVEF cohort with the mean difference of - 1.05 (- 1.96 to - 0.15) mL/kg/min, after adjustment for age-squared, gender, anemia, renal function, LVEF, and log B-type natriuretic peptide (BNP). The adjusted VO(2)at anaerobic threshold (AT), a submaximal aerobic capacity, was also decreased in the diabetic patients with both non-reduced and reduced LVEFs. Intriguingly, the diabetic patients had a lower adjusted peak O(2)pulse than the nondiabetic patients in the reduced LVEF cohort, but not in the non-reduced LVEF cohort. A multivariate analysis showed that the presence of T2DM was an independent predictor of lowered peak VO(2)in CHF patients with non-reduced LVEF and those with reduced LVEF. Conclusions T2DM was associated with lowered peak VO(2)in CHF patients with non-reduced or reduced LVEF. The presence of T2DM has a negative impact on CHF patients' exercise capacity, and the degree of impact is partly dependent on their LV systolic function.

引用

页数：10

共 42 条

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