Study of exercise treadmill test in type 2 diabetes mellitus patients

Background: The aim of this study was to assess the prevalence and clinical predictors of silent myocardial ischemia in patients with type 2 diabetes mellitus, and the early diagnosis of coronary artery disease.Methods: A cross sectional prospective study was conducted including all confirmed diabetic patients in the age group between 40-60 in Bharati medical college hospital Pune in western Maharashtra. A detailed clinical examination and history was taken and relevant laboratory investigations, Electrocardiogram and Treadmill Stress test was done using Bruce protocol. The quantitative data was represented as their mean ± SD. Categorical and nominal data was expressed in percentage. All analysis was carried out by using SPSS software version 21.Results: Male preponderance was seen in the study with 64% of the study subjects. The mean age of the study subjects was 50.67±5.51 years. A p<0.001 was obtained showing positive correlation between BMI and TMT positivity. TMT positivity steadily increased with the duration of diabetes mellitus. Obtained p<0.001. The correlation between dyslipidemia and TMT positivity was significant, with a p=0.007. Correlation of Fasting as well as Post-prandial blood glucose levels with TMT positivity proved to be statistically significant, with a p<0.001.Conclusions: Exercise Treadmill test in diabetic patients has a significant role in screening diabetic individuals for coronary ischemia. The results obtained clearly indicate that an exercise treadmill test may be proposed as the first test for screening for coronary ischemia in diabetic population as it is safer, cheaper and non-invasive.

Exercise Treadmill Test in Patients with Diabetes Mellitus Type 2

There is a concern regarding the high incidence of coronary heart disease (CHD) among patients with diabetes mellitus (DM) type 2 since it is a leading cause of mortality in those patients. Exercise treadmill test (ETT) is proposed as a suitable, non-invasive method for identifying asymptomatic patients with ischemic changes, who would benefit from pharmacological treatment, thus contributing to a reduction of adverse cardiovascular events. Therefore the objective of our study was to evaluate myocardial ischemia in asymptomatic patients with DM type 2 by performing ETT. The present investigation was conducted in Health Center Pozega during the year 2018. 40 insulin-dependent, aged 33.05 ± 2.01 years, with DM type 2 were included in the study. They had nor history nor symptoms of cardiac disease. All patients underwent ETT according to Bruce protocol, while 12-lead ECG was recorded and blood pressure was monitored. All patients had negative ETT results. Also no ST segment depression, no signs of insufficiency of peripheral circulation, no changes in heart rhythm, no symptoms by the central nervous system were observed. Additionally response of heart rate and blood pressure to exercise was within physiological range. These promising findings indicate that diabetes didn’t alter myocardial integrity and function, thus suggesting that coronary reserve in examined patients was preserved.

Is Heart Rate Recovery Really Associated with Severity of Coronary Artery Disease in Patients with Normal Exercise Treadmill Test?

Background and Objectives: Rapid diagnosis and treatment of cardiovascular diseases is really helpful in reducing further complications. There are different modalities for this goal but each has benefits and limitations. Exercise Treadmill Test (ETT) is a non-invasive, cheap and accessible test. Coronary CT Angiography (CTA) is recently considered as an applied modality for assessing severity of Coronary Artery Disease (CAD). In this study we aimed to investigate possible association between Heart Rate Recovery (HRR) in ETT and severity of CAD in CTA.

Increasing Age, Diabetes Mellitus and Beta Blocker Influence Heart Rate Recovery Values in Patients Undergoing Exercise Treadmill Test

Background: Heart disease is the number one cause of death globally. This disease is initiation affected by autonomic dysfunction which will cause disruption of the sympathetic-parasympathetic system. Heart Rate Recovery (HRR) is used to determineautonomic dysfunction.Objective: To determine the relationship of risk factors and cardiovascular treatment to HRR values of 1 minute and 2 minutes.Methods: Cross sectional study to measure HRR 1 and 2 minute undergoing exercise treadmill test for the screening of coronary heart disease in Saiful Anwar hospital in May 2016 until September 2017. Univariate analysis was performed to determine the frequency and proportion of HRR values classified into normal groups (HRR 1 minute > 12x / minute or HRR 2 minutes > 22x / minute) and abnormal groups (HRR 2 minutes ≤ 12x / minute or HRR 2 minutes ≤ 22x / minute).We also performed bivariate analysis using comparative test (Generalized Linear Model) and correlation test (Pearson, Spearman and Eta) and multivariate linear regression analysis.Results: This study found that age, hypertension and beta blocker were significantly associated with HRR abnormalities (p<0.05). HRR 1 and HRR 2 were significantly associated with diabetes mellitus (DM) (p=0.004 and p=0.039) and beta blocker (p=0.042 and p=0.039). Then looking at the relationship of multivariate correlations found a significant correlation between age (β=-0.133, p=0.000) and DM (β=-2.617, p=0.032) at 1 minute HRR and significant correlation with age (β=-0.165, p=0.004) and beta blockers (β=-2,947, p=0.017).Conclusion: increasing of age, diabetes mellitus and beta blockers correlate with decreasing of HRR. The most influential risk factors for HRR values of 1 minute were increasing age and DM, while for HRR values of 2 minutes were increasing age and beta blockers.