Kodai Ishihara1, Tomoyuki Morisawa2, Junko Kawada3, Yuko Nagare3, Takuya Koyama3, Hikari Yagi3, Mayuko Sueoka3, Toshinobu Yoshida4, Akira Tamaki5. 1. Department of Rehabilitation, the Sakakibara Heart Institute of Okayama. 2. Department of Physical Therapy, Faculty of Health Sciences, Juntendo University. 3. Department of Laboratory Medicine, the Sakakibara Heart Institute of Okayama. 4. Department of Cardiovascular Medicine, the Sakakibara Heart Institute of Okayama. 5. Graduate School of Health Sciences, Hyogo University of Health Sciences.
Abstract
PURPOSE: The purpose of this study was to clarify the influence of complications of diabetes on the exercise tolerance of patients with heart failure. METHODS: The subjects of this study were 69 patients (44 men; mean age: 62.2 ± 13.4 years) who were hospitalized and diagnosed with heart failure between November 2016 and November 2017. The subjects all took part in a cardiopulmonary exercise test. The patients' medical background, indexes obtained from lower-limb muscle strength and the cardiopulmonary exercise test, heart rate response indexes [Δ heart rate (ΔHR)], and autonomic nervous activities were measured, and these individual indexes were compared between the diabetic group and the non-diabetic group. RESULTS: Compared with the non-diabetic group, the peak oxygen uptake (peak V̇O2) and ΔHR in the diabetic group were significantly lower (13.0 ± 2.2 vs. 14.9 ± 4.4 ml/kg/min and 27.2 ± 11.7 vs. 36.7 ± 14.7 bpm, respectively) (p<0.05). Regarding the autonomic nervous activity during the cardiopulmonary exercise test in the diabetic group, there was a significant decrease of parasympathetic nerve activity and a significant lack of increase in sympathetic nerve activity (p<0.05). CONCLUSIONS: Patients with heart failure and diabetes had lower levels of exercise tolerance, as compared with patients without complications. It was suggested that the decrease in heart rate response was due to the decrease of autonomic nervous activity and that this may play a role in reduced exercise tolerance. 2019, JAPANESE PHYSICAL THERAPY ASSOCIATION.
PURPOSE: The purpose of this study was to clarify the influence of complications of diabetes on the exercise tolerance of patients with heart failure. METHODS: The subjects of this study were 69 patients (44 men; mean age: 62.2 ± 13.4 years) who were hospitalized and diagnosed with heart failure between November 2016 and November 2017. The subjects all took part in a cardiopulmonary exercise test. The patients' medical background, indexes obtained from lower-limb muscle strength and the cardiopulmonary exercise test, heart rate response indexes [Δ heart rate (ΔHR)], and autonomic nervous activities were measured, and these individual indexes were compared between the diabetic group and the non-diabetic group. RESULTS: Compared with the non-diabetic group, the peak oxygen uptake (peak V̇O2) and ΔHR in the diabetic group were significantly lower (13.0 ± 2.2 vs. 14.9 ± 4.4 ml/kg/min and 27.2 ± 11.7 vs. 36.7 ± 14.7 bpm, respectively) (p<0.05). Regarding the autonomic nervous activity during the cardiopulmonary exercise test in the diabetic group, there was a significant decrease of parasympathetic nerve activity and a significant lack of increase in sympathetic nerve activity (p<0.05). CONCLUSIONS:Patients with heart failure and diabetes had lower levels of exercise tolerance, as compared with patients without complications. It was suggested that the decrease in heart rate response was due to the decrease of autonomic nervous activity and that this may play a role in reduced exercise tolerance. 2019, JAPANESE PHYSICAL THERAPY ASSOCIATION.
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