Abnormal glucose metabolism is associated with reduced left ventricular contractile reserve and exercise intolerance in patients with chronic heart failure
Abstract
AIMS: To investigate the associations between glucose metabolism, left ventricular (LV) contractile reserve, and exercise capacity in patients with chronic systolic heart failure (HF). METHODS AND RESULTS: From an outpatient HF clinic, 161 patients with systolic HF were included (mean age 70 ± 10 years, 69% male, 59% had ischaemic heart disease, mean LV ejection fraction (LVEF) 37 ± 9%). Thirty-four (21%) patients had known diabetes mellitus (DM). Oral glucose tolerance testing (OGTT) classified patients without a prior DM diagnosis as normal glucose tolerance (NGT), impaired glucose tolerance or new DM. All patients completed low-dose dobutamine echocardiography (LDDE) and 154 patients a 6-min walking distance test (6MWD). Compared with patients with NGT, patients with known DM had lower resting LVEF (33.4 vs. 39.1%, P < 0.05) and higher E/e' (13.9 vs. 11.4, P < 0.05). During LDDE, an increase in LVEF could be observed in all glycemic groups (mean 8.2% absolute increase), but the contractile reserve was lower in patients with known DM (-5.4%, P = 0.001) and new DM (-3.5%, P = 0.035) compared to patients with NGT. 6MWD was lower in known DM (349 m) and new DM (379 m) compared with NGT (467 m) (P < 0.001). Differences in clinical variables, resting echocardiographic parameters or contractile reserve, did not explain the exercise intolerance related to diabetes. CONCLUSION: Diabetes, known or newly detected by OGTT, is independently associated with reduced LV contractile reserve and exercise intolerance in outpatients with systolic HF. These findings may offer one explanation for the excess mortality related to diabetes in HF.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Patients with T2DM and HFrEF have shorter 6-minute walk distances and decreased peak oxygen uptake compared to non-diabetics.
“Patients with T2DM and HFrEF also have shorter 6-minute walk distances and decreased peak oxygen uptake in comparison to non-diabetics.55,69,72”
From Type 2 diabetes mellitus and heart failure: A position statement from the Heart Failure Association of the European Society of Cardiology (2018) · cites this paper as [72]
Cites
Matthews, D. R., Hosker, J. P., Rudenski, A. S., Naylor, B. A., Treacher, D. F., & Turner, R. C. (1985) · Diabetologia · doi:10.1007/bf00280883 · Cited by 31,502 · see citing works
Diagnosis and Classification of Diabetes Mellitus
American Diabetes Association (2010) · Diabetes Care · doi:10.2337/dc11-s062 · Cited by 14,019 · see citing works
Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography
Nagueh, S. F., Appleton, C. P., Gillebert, T. C., Marino, P. N., Oh, J. K., Smiseth, O. A., Waggoner, A. D., Flachskampf, F. A., Pellikka, P. A., & Evangelista, A. (2009) · Journal of the American Society of Echocardiography · doi:10.1016/j.echo.2008.11.023 · Cited by 4,367 · see citing works
ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008
Dickstein, K., Authors Task Force Members, Solal, A. C., Filippatos, G. S., McMurray, J. J. V., Ponikowski, P. P., Poole-Wilson, P. A., Strömberg, A., van Veldhuisen, D. J., Atar, D., et al. (2008) · European Journal of Heart Failure · doi:10.1016/j.ejheart.2008.08.005 · Cited by 3,515 · see citing works
Recommendations for the evaluation of left ventricular diastolic function by echocardiography
Nagueh, S. F., Appleton, C. P., Gillebert, T. C., Marino, P. N., Oh, J. K., Smiseth, O. A., Waggoner, A. D., Flachskampf, F. A., Pellikka, P. A., & Evangelisa, A. (2008) · European Journal of Echocardiography · doi:10.1093/ejechocard/jep007 · Cited by 3,351 · see citing works
MacDonald, M. R., Petrie, M. C., Varyani, F., Ostergren, J., Michelson, E. L., Young, J. B., Solomon, S. D., Granger, C. B., Swedberg, K., Yusuf, S., et al. (2008) · European Heart Journal · doi:10.1093/eurheartj/ehn153 · Cited by 694 · see citing works
Systematic review of the association between lung function and Type 2 diabetes mellitus
Klein, O. L., Krishnan, J. A., Glick, S., & Smith, L. J. (2010) · Diabetic Medicine · doi:10.1111/j.1464-5491.2010.03073.x · Cited by 275 · see citing works
Prior, J. O., Quiñones, M. J., Hernandez‐Pampaloni, M., Facta, A. D., Schindler, T. H., Sayre, J. W., Hsueh, W. A., & Schelbert, H. R. (2005) · Circulation · doi:10.1161/01.cir.0000164232.62768.51 · Cited by 275 · see citing works
Suskin, N. (2000) · European Heart Journal · doi:10.1053/euhj.1999.2043 · Cited by 271 · see citing works
Gustafsson, I., Brendorp, B., Seibæk, M., Burchardt, H., Hildebrandt, P., Køber, L., & Torp-Pedersen, C. (2004) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2003.11.024 · Cited by 258 · see citing works
Self-citationPrognostic value of dobutamine echocardiography in patients with left ventricular dysfunction
Williams, M., Odabashian, J. A., Lauer, M. S., et al. (1996) · Journal of the American College of Cardiology · doi:10.1016/0735-1097(95)00393-2 · Cited by 203 · see citing works
The Effect of Diabetes on Expression of β1-,β2-, and β3-Adrenoreceptors in Rat Hearts
Dinçer, Ü. D., Bidasee, K. R., Güner, Ş., Tay, A., Ozcelikay, A. T., & ALTAN, V. M. (2001) · Diabetes · doi:10.2337/diabetes.50.2.455 · Cited by 172 · see citing works
Muscle metaboreceptors in hemodynamic, autonomic, and ventilatory responses to exercise in men
Piepoli, M. F., Clark, A. L., & Coats, A. J. S. (1995) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.1995.269.4.h1428 · Cited by 127 · see citing works
Sacre, J. W., Franjic, B., Jellis, C. L., Jenkins, C., Coombes, J. S., & Marwick, T. H. (2010) · JACC: Cardiovascular Imaging · doi:10.1016/j.jcmg.2010.09.014 · Cited by 123 · see citing works
Early diastolic impairment of diabetic heart: The significance of right ventricle
Karamitsos, T. D., Karvounis, H. I., Dalamanga, E., et al. (2006) · International Journal of Cardiology · doi:10.1016/j.ijcard.2006.02.003 · Cited by 102 · see citing works
Dinh, W., Lankisch, M., Nickl, W., Scheyer, D., Scheffold, T., Kramer, F., Krahn, T., Klein, R. M., Barroso, M. C., & Füth, R. (2010) · Cardiovascular Diabetology · doi:10.1186/1475-2840-9-63 · Cited by 87 · see citing works
Ramahi, T. M. (2001) · European Heart Journal · doi:10.1053/euhj.2001.2654 · Cited by 64 · see citing works
Goode, K. M., John, J., Rigby, A. S., Kilpatrick, E. S., Atkin, S. L., Bragadeesh, T., Clark, A. L., & Cleland, J. G. F. (2009) · Heart · doi:10.1136/hrt.2008.156646 · Cited by 58 · see citing works
Hamdan, A., Shapira, Y., Gal, T. B., et al. (2006) · The Journal of Heart and Lung Transplantation · doi:10.1016/j.healun.2005.09.002 · Cited by 54 · see citing works
Impaired Inotropic Response in Type 2 Diabetes Mellitus: A Strain Rate Imaging Study
Galderisi, M., SIMONE, G. D., Innelli, P., Turco, A., Turco, S., Capaldo, B., Riccardi, G., & Dedivitiis, O. (2007) · American Journal of Hypertension · doi:10.1016/j.amjhyper.2006.12.009 · Cited by 53 · see citing works
Sicari, R., Picano, E., Cortigiani, L., et al. (2003) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2003.08.004 · Cited by 53 · see citing works
Diabetes lowers six-minute walk test performance in heart failure
Ingle, L., Reddy, P., Clark, A. L., & Cleland, J. G. F. (2006) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2006.02.005 · Cited by 51 · see citing works
Terzi, S., Sayar, N., Bilsel, T., et al. (2007) · Heart and Vessels · doi:10.1007/s00380-006-0961-x · Cited by 50 · see citing works
Myocardial mechanical and myosin isoenzyme alterations in streptozotocin-diabetic rats.
Takeda, N., Nakamura, I., Hatanaka, T., Ohkubo, T., & Nagano, M. (1988) · Japanese Heart Journal · doi:10.1536/ihj.29.455 · Cited by 48 · see citing works
Egstrup, M., Schou, M., Gustafsson, I., Kistorp, C., Hildebrandt, P. R., & Tuxen, C. (2010) · European Journal of Heart Failure · doi:10.1093/eurjhf/hfq216 · Cited by 44 · see citing works
Self-citationHa, J., Ahn, J., Kim, J., et al. (2006) · Journal of the American Society of Echocardiography · doi:10.1016/j.echo.2006.05.022 · Cited by 38 · see citing works
Govind, S. C., SAHA, S., Brodin, L. A., et al. (2006) · American Journal of Hypertension · doi:10.1016/j.amjhyper.2006.01.005 · Cited by 38 · see citing works
Otašević, P., Popović, Z., Vasiljevic, J. D., et al. (2004) · European Journal of Heart Failure · doi:10.1016/j.ejheart.2004.01.017 · Cited by 37 · see citing works
Kotsanas, G. (2000) · Cardiovascular Research · doi:10.1016/s0008-6363(00)00062-6 · Cited by 35 · see citing works
Decreased Survival in Diabetic Patients with Heart Failure Due to Systolic Dysfunction
Kamalesh, M., Subramanian, U., Sawada, S. G., Eckert, G. J., Temkit, M., & Tierney, W. M. (2005) · European Journal of Heart Failure · doi:10.1016/j.ejheart.2005.10.005 · Cited by 34 · see citing works
Diabetes Lowers Aerobic Capacity in Heart Failure
Tibb, A. S., Ennezat, P. V., Chen, J. A., Haider, A., Gundewar, S., Cotarlan, V., Aggarwal, V. S., Talreja, A., & Jemtel, T. H. L. (2005) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2005.06.001 · Cited by 29 · see citing works
Yazıcı, M., Özdemir, K., Gönen, M. S., et al. (2008) · Echocardiography · doi:10.1111/j.1540-8175.2008.00690.x · Cited by 23 · see citing works
Govind, S. C., Brodin, L., Nowak, J., Quintana, M., Raumina, S., Ramesh, S. S., Keshava, R., & Saha, S. K. (2005) · Cardiology · doi:10.1159/000085126 · Cited by 17 · see citing works
Straburzyńska‐Migaj, E., Ochotny, R., & Cieśliński, A. (2007) · PubMed · Cited by 5 · see citing works
Govind, S. C., Brodin, L., Nowak, J., et al. (2007) · Scandinavian Cardiovascular Journal · doi:10.1080/14017430701604598 · Cited by 3 · see citing works
Alberti (1998) · doi:10.1002/(sici)1096-9136(199807)15:7
Flagged first, then by citations
Cited by
Sorted by citations
Seferović, P. M., Petrie, M. C., Filippatos, G. S., Anker, S. D., Rosano, G., Bauersachs, J., Paulus, W. J., Komajda, M., Cosentino, F., de Boer, R. A., et al. (2018) · European Journal of Heart Failure · doi:10.1002/ejhf.1170 · Cited by 708 · see citing works
- Authors
- Egstrup, M., Kistorp, C. N., Schou, M., Hofsten, D. E., Moller, J. E., Tuxen, C. D., & Gustafsson, I.
- Affiliations
- Frederiksberg Hospital (DK)
- Herlev Hospital (DK)
- Rigshospitalet (DK)
- Bispebjerg Hospital (DK)
- Corresponding author
- Egstrup, M.
- Venue
- European Heart Journal - Cardiovascular Imaging
- Publisher
- Oxford University Press (OUP)
- Published
- 2012-08-16
- Volume
- 14
- Issue
- 4
- Pages
- 349-357
- ISSN
- 2047-2404 (ISSN-L)
- 2047-2412
- OpenAlex
- W2164075916
- Cited by
- 21
- References
- 36
- Citations by year
- 2023: 1 · 2021: 1 · 2020: 4 · 2019: 4 · 2018: 1 · 2017: 2 · 2015: 1 · 2014: 4 · 2013: 3
- FWCI
- 1.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Heart Journal - Cardiovascular Imaging (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Keywords
- chronic systolic heart failure, diabetes mellitus, glucose metabolism, impaired glucose tolerance, left ventricular contractile reserve, exercise intolerance, oral glucose tolerance test, 6-minute walk distance, left ventricular ejection fraction, E/e' ratio
- MeSH terms
- Aged, Aged, 80 and over, Blood Glucose, Diabetes Mellitus, Exercise Test, Female, Humans, Male, Middle Aged, Myocardial Contraction, Prognosis, Retrospective Studies, Severity of Illness Index, Cohort Studies, Exercise Tolerance, Ventricular Dysfunction, Left, Risk Assessment, Echocardiography, Stress, Heart Failure, Systolic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
