P4408Cardiovascular response in diabetic patients submitted to treadmill electrocardiographic exercise stress test

Abstract Introduction Diabetes mellitus (DM) is an entity commonly associated with neuropathy, a factor that may have repercussions on the cardiovascular system, specifically in its capacity to respond to stimuli. Objectives To evaluate the cardiovascular response to exercise in diabetic patients, comparing it with a control group. Methods Patients who underwent treadmill eletrocardiographic exercise stress test (EST) between January 2016 and November 2018 without the influence of negative chronotropic medication were included. Results A total of 187 patients were identified, having a mean age of 57±13 years, of whom 120 (64%) were of the male gender. Eighty-four (45%) were diabetic. The group of diabetic patients had a higher prevalence of arterial hypertension, however the number of classes of antihypertensive drugs was not significantly different between diabetic and non-diabetic patients. There were no significant differences in the remaining demographic variables. Patients with DM presented lower maximal heart rates (HR) (141±14 vs 148±19 beats/minute, p=0.015), lower HT reserve (59±16 vs 67±21 beats/minute, p=0.005), as well as a lower rate of HR fall in the recovery period (13±5 vs 16±5 beats/minute2, p<0.001). Total EST time was also lower in diabetic patients (median 7.0 IQR=3 vs 7.3 IQR=3.5 minutes, p=0.044). Additionally, the number of years since the time of diagnosis of DM was inversely correlated with the degree of increase in systolic blood pressure (SBP) with exercise (r=−0.22, p=0.045), and the pre-test SBP (median 135 IQR=24 vs 130 IQR=20 mmHg, p=0.048) and post-test SBP (median 150 IQR=20 vs 140 IQR=25 mmHg, p=0.007) were higher in patients with DM. Discussion In this study it was found that patients with DM present an impaired chronotropic response, both in exercise and recovery periods, and it was observed that the capacity to increase SBP is inversely correlated to the duration of DM. These data may reflect the neuropathic involvement in DM and its influence in the cardiovascular response to exercise.

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Systolic Blood Pressure Response to Exercise Stress Test and Risk of Stroke

Stroke ◽

10.1161/hs0901.095395 ◽

2001 ◽

Vol 32 (9) ◽

pp. 2036-2041 ◽

Cited By ~ 156

Author(s):

S. Kurl ◽

J.A. Laukkanen ◽

R. Rauramaa ◽

T.A. Lakka ◽

J. Sivenius ◽

...

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Blood Pressure Response ◽

Stress Test ◽

Exercise Stress Test ◽

Pressure Response ◽

Exercise Stress ◽

Response To Exercise

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THU0320 Cardiovascular Response to Submaximal Exercise Stress Test in Fibromyalgia Women

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2015-eular.6121 ◽

2015 ◽

Vol 74 (Suppl 2) ◽

pp. 311.2-311

Author(s):

O. Dzekan ◽

M. Stanislavchuk

Keyword(s):

Cardiovascular Response ◽

Stress Test ◽

Exercise Stress Test ◽

Submaximal Exercise ◽

Exercise Stress

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Safety and feasibility of dobutamine-atropine stress echocardiography for the diagnosis of coronary artery disease in diabetic patients unable to perform an exercise stress test

Diabetes Care ◽

10.2337/diacare.21.11.1797 ◽

1998 ◽

Vol 21 (11) ◽

pp. 1797-1802 ◽

Cited By ~ 56

Author(s):

A. Elhendy ◽

R. T. van Domburg ◽

D. Poldermans ◽

J. J. Bax ◽

P. R. Nierop ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Stress Echocardiography ◽

Stress Test ◽

Exercise Stress Test ◽

Exercise Stress ◽

Diabetic Patients ◽

Artery Disease

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Emergency department patient compliance with follow-up for outpatient exercise stress testing: a randomized controlled trial

CJEM ◽

10.1017/s1481803500015463 ◽

2007 ◽

Vol 9 (06) ◽

pp. 435-440 ◽

Cited By ~ 24

Author(s):

Doug Richards ◽

Nazanin Meshkat ◽

Jaqueline Chu ◽

Kevin Eva ◽

Andrew Worster

Keyword(s):

Chest Pain ◽

Stress Testing ◽

Stress Test ◽

Intervention Group ◽

Exercise Stress Test ◽

Low Risk ◽

Exercise Stress ◽

Exercise Stress Testing ◽

Control Group

ABSTRACTIntroduction:Numerous patients are assessed in the emergency department (ED) for chest pain suggestive of acute coronary syndrome (ACS) and subsequently discharged if found to be at low risk. Exercise stress testing is frequently advised as a follow-up investigation for low-risk patients; however, compliance with such recommendations is poorly understood. We sought to determine if compliance with follow-up for exercise stress testing is higher in patients for whom the investigation is ordered at the time of ED discharge, compared with patients who are advised to arrange testing through their family physician (FP).Methods:Low-risk chest pain patients being discharged from the ED for outpatient exercise stress test and FP follow-up were randomized into 2 groups. ED staff ordered an exercise stress test for the intervention group, and the control group was advised to contact their FP to arrange testing. The primary outcome was completion of an exercise stress test at 30 days, confirmed through both patient contact and stress test results. Patients were unaware that our primary interest was their compliance with the exercise stress testing recommendations.Results:Two-hundred and thirty-one patients were enrolled and baseline characteristics were similar between the 2 groups. Completion of an exercise stress test at 30 days occurred in 87 out of 120 (72.5%) patients in the intervention group and 60 out of 107 (56.1%) patients in the control group. The difference in compliance rates (16.4%) between the 2 groups was statistically significant (χ2= 6.69,p< 0.001) with a relative risk of 1.29 (95% confidence interval 1.18–1.40), and the results remained significant after a “worst case” sensitivity analysis involving 4 control group cases lost to follow-up. When subjects were contacted by telephone 30 days after the ED visit, 60% of those who were noncompliant patients felt they did not have a heart problem and that further testing was unnecessary.Conclusion:When ED staff order an outpatient exercise stress test following investigation for potential ACS, patients are more likely to complete the test if it is booked for them before ED discharge. After discharge, many low-risk chest pain patients feel they are not at risk and do not return to their FP for further testing in a timely manner as advised. Changing to a strategy of ED booking of exercise stress testing may help earlier identification of patients with coronary heart disease.

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Caffeine Improves Hormonal and Lactate Homeostasis in Diabetic Rats

Current Nutrition & Food Science ◽

10.2174/1573401314666180515143951 ◽

2019 ◽

Vol 15 (6) ◽

pp. 621-626

Author(s):

Luiz A. da Silva ◽

Jéssica Wouk ◽

Vinícius M.R. Weber ◽

Pablo de Almeida ◽

Julio C.L. Martins ◽

...

Keyword(s):

Stress Test ◽

Lactate Concentration ◽

Intraperitoneal Administration ◽

Exercise Stress Test ◽

Diabetic Rats ◽

Exercise Stress ◽

Control Group ◽

Steady State Condition ◽

Significant Difference ◽

Lactate Minimum

Introduction: Lactate Minimum Test (LMT) identifies a sustainable exercise intensity, in which an equilibrium is observed between production and clearance of blood lactate and the hormone influence during this physiological moment. Objective: The present study aimed to identify the levels of LM and hormones after caffeine consumption and exercise Stress Test (ST) in diabetic rats. Methods: This study was composed of 24 animals, of 60 days, allocated into four groups: Control, Diabetic, Caffeine, and Diabetes+Caffeine. The Diabetes model was induced by intraperitoneal administration of 120 mg/kg of alloxan. On the test day, 6 mg/kg of caffeine were administrated 30 minutes before the exercise Stress Test (ST) protocol. During the ST animals underwent a Stress Test (ST), in which they performed forced swimming (until exhaustion) tie to loads of 13% Body’s Weight (BW). The incremental phase of LM began with an initial load of 4% Body’s Weight (BW) and increased 0.5% every 5 min. Lactate concentration was measured 5, 7 and 9 min (mmol/L) after ST. The Incremental Progressive Test (IPT) involved swimming with loads of 4.0, 4.5, 5.0, 5.5, 6.0, and 7.0% of BW, for 5min with each. Blood samples were collected by a caudal puncture to subsequent lactate and hormone assay. Results: Performance time and lactate concentration of hyperlactatemia test, as well as Lactate Minimum (LM) and Lactate (LAC) concentration after the progressive test presented a significant difference when comparing the levels of the control group with caffeine and diabetic group (p<0.05). Conclusion: It is suggested that caffeine improves lactate clearance and hormonal steady state condition of diabetic animals after hyperlactacidemia and physical exercise maintenance.

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