Yamato Fukuda1, Kumiko Yoshimura2, Yoshiharu Fukuda2, Nobuo Fukuda3. 1. Department of Cardiology and Clinical Research, National Hospital Organization Zentsuji Hospital, Senyu-cho 2-1-1, Zentsuji, Kagawa, 765-0806, Japan. svx@muse.dti.ne.jp. 2. Department of Cardiology, Fukuda Cardiovascular Surgery and Digestive Internal Medicine Clinic, Higashijinzenji 67-1, Kochi, 780-0023, Japan. 3. Department of Cardiology and Clinical Research, National Hospital Organization Zentsuji Hospital, Senyu-cho 2-1-1, Zentsuji, Kagawa, 765-0806, Japan.
Abstract
BACKGROUND: No relationship between the ratio of peak early velocity of left ventricular inflow to peak systolic longitudinal velocity of the mitral annulus velocity (E/e') and insulin resistance has yet been shown in patients with cardiac disease. We hypothesized that patients with high E/e' values would tend not to show the rapid blood glucose-lowering in response to exercise training characteristic of impaired glucose tolerance (IGT) or diabetes mellitus (DM) patients. METHODS: The subjects were continuous IGT/DM patients (n = 27) participating in cardiac rehabilitation. All patients' E/e' values were measured by echocardiography. The patients' blood glucose levels (mg/dl) were measured just before (pre-BS) and after (post-BS) exercise training. Post-BS was subtracted from pre-BS to obtain ΔBS, and the relationship between E/e' and ΔBS was investigated. RESULTS: E/e' correlated negatively with ΔBS. Moreover, E/e' was a significant predictor of ΔBS and as such was independent of hemoglobin A1c (HbA1c), pre-BS, and presence of atrial fibrillation on multivariate analysis. CONCLUSIONS: Patients with high E/e', indicating high left ventricular filling pressure, were unlikely to exhibit the rapid glucose-lowering response.
BACKGROUND: No relationship between the ratio of peak early velocity of left ventricular inflow to peak systolic longitudinal velocity of the mitral annulus velocity (E/e') and insulin resistance has yet been shown in patients with cardiac disease. We hypothesized that patients with high E/e' values would tend not to show the rapid blood glucose-lowering in response to exercise training characteristic of impaired glucose tolerance (IGT) or diabetes mellitus (DM) patients. METHODS: The subjects were continuous IGT/DMpatients (n = 27) participating in cardiac rehabilitation. All patients' E/e' values were measured by echocardiography. The patients' blood glucose levels (mg/dl) were measured just before (pre-BS) and after (post-BS) exercise training. Post-BS was subtracted from pre-BS to obtain ΔBS, and the relationship between E/e' and ΔBS was investigated. RESULTS: E/e' correlated negatively with ΔBS. Moreover, E/e' was a significant predictor of ΔBS and as such was independent of hemoglobin A1c (HbA1c), pre-BS, and presence of atrial fibrillation on multivariate analysis. CONCLUSIONS:Patients with high E/e', indicating high left ventricular filling pressure, were unlikely to exhibit the rapid glucose-lowering response.
Authors: S R Ommen; R A Nishimura; C P Appleton; F A Miller; J K Oh; M M Redfield; A J Tajik Journal: Circulation Date: 2000-10-10 Impact factor: 29.690
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