Cardiorespiratory fitness and right ventricular mechanics in uncomplicated diabetic patients: Is there any relationship? Acta Diabetologica

V. Vukomanovic, J. Suzic-Lazic, V. Celic, C. Cuspidi, D. Skokic, A. Esposito, G. Grassi, M. Tadic

Research output: Contribution to journalArticlepeer-review


Aims: This study investigated the association between cardiorespiratory fitness and right ventricular (RV) strain in uncomplicated diabetic patients. Methods: This cross-sectional study involved 70 controls and 61 uncomplicated patients with type 2 diabetes, who underwent laboratory analysis, comprehensive echocardiographic study and cardiopulmonary exercise testing. Results: RV endocardial and mid-myocardial longitudinal strains were significantly reduced in diabetic subjects (− 27.5 ± 4.2% vs. − 25.3 ± 4.3%, p = 0.004 for endocardial strain; − 25.6 ± 3.5% vs. − 24.1 ± 3.2%, p = 0.012 for mid-myocardial strain). The same was revealed for endocardial and mid-myocardial of RV free wall. There was no difference in RV epicardial strain. VO2 was significantly lower in the diabetic group (27.8 ± 4.5 ml/kg/min vs. 21.5 ± 4.2 ml/kg/min, p < 0.001), whereas ventilation/carbon dioxide slope was significantly higher in diabetic subjects (25.4 ± 2.9 vs. 28.6 ± 3.3). Heart rate recovery was significantly lower in diabetic patients. HbA1c and global RV endocardial longitudinal strain were independently associated with peak VO2 and oxygen pulse in the whole study population. Conclusion: Diabetes impacts RV mechanics, but endocardial and mid-myocardial layers are more affected than epicardial layer. RV endocardial strain and HbA1c were independently associated with cardiorespiratory fitness in the whole study population. Our findings show that impairment in RV strain and cardiorespiratory fitness may be useful indicators in early type 2 diabetes, prior to the development of further complications. © 2019, Springer-Verlag Italia S.r.l., part of Springer Nature.
Original languageEnglish
Pages (from-to)425-431
Number of pages7
JournalActa Diabetol.
Issue number4
Publication statusPublished - 2020


  • Diabetes
  • Oxygen uptake
  • Right ventricular strain
  • hemoglobin A1c
  • adult
  • Article
  • body mass
  • body surface
  • cardiopulmonary exercise test
  • cardiorespiratory fitness
  • cardiovascular parameters
  • controlled study
  • cross-sectional study
  • disease association
  • early diastolic mitral flow
  • echocardiography
  • female
  • heart ejection fraction
  • heart left ventricle ejection fraction
  • heart rate
  • heart rate recovery
  • heart right ventricle function
  • heart right ventricle overload
  • hemoglobin blood level
  • human
  • interventricular septum
  • late diastolic mitral flow
  • left ventricle end diastolic dimension
  • left ventricular mass index
  • lung gas exchange
  • lung ventilation
  • major clinical study
  • male
  • middle aged
  • non insulin dependent diabetes mellitus
  • oxygen consumption
  • priority journal
  • pulmonary artery systolic pressure
  • right atrial volume index
  • tricuspid annular plane systolic excursion
  • ventilation carbon dioxide slope
  • biomechanics
  • case control study
  • diagnosis
  • exercise test
  • metabolism
  • pathophysiology
  • physiology
  • Adult
  • Biomechanical Phenomena
  • Cardiorespiratory Fitness
  • Case-Control Studies
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2
  • Exercise Test
  • Female
  • Heart Rate
  • Humans
  • Male
  • Middle Aged
  • Oxygen Consumption
  • Ventricular Dysfunction, Right
  • Ventricular Function, Right


Dive into the research topics of 'Cardiorespiratory fitness and right ventricular mechanics in uncomplicated diabetic patients: Is there any relationship? Acta Diabetologica'. Together they form a unique fingerprint.

Cite this