Background
Methods
Study population
Cardiopulmonary exercise test
Body composition
Oral glucose tolerance test
Coronary flow reserve and echocardiography
Statistics
Results
Patient characteristics n = 65 | Median/number | IQ range/percentage |
---|---|---|
Age | 63 | (58–67) |
Male Sex | 54 | (83.1 %) |
Fat percentage (%) | 34.0 | (30.5–38.6) |
BMI (kg/m2) | 31.3 | (29.7–33.7) |
Prediabetes | 47 | (72.3 %) |
Predicted VO2peak (%) | 93.9 % | (84.6–109.2) |
VO2peakBW (ml/min/kg) | 20.9 | (17.3–25.1) |
VO2peakFFM (ml/min/kg FFM(2/3)) | 127 | (108.8–145.6) |
Respiratory exchange ratio | 1.19 | (1.16–1.26) |
ICD | 2 | (3.1 %) |
Systolic blood pressure (mmHg) | 127 | (118–135) |
Diastolic blood pressure (mmHg) | 72 | (67–79) |
Medication | ||
-Beta-blockers
-Statins
-ASA or/and Clopidogrel
-Diuretics
-ACE-inhibitors
| 34 63 62 21 29 | (52.3 %) (96.9 %) (95.4 %) (32.3 %) (44.6 %) |
Atrial fibrillation | 3 | (4.6 %) |
Left ventricular ejection fraction (%) | 54 | (46–59) |
Ischemic etiology | ||
-Previous PCI or CABG
Involving LAD
-Previous myocardial infarction
Involving LAD
| 57 36 35 15 | (87.7 %) (55.4 %) (53.9 %) (23.1 %) |
CCS-class | ||
-| | 13 | (20.0 %) |
NYHA-class | ||
-| -|| -||| | 50 14 1 | (76.9 %) (21.5 %) (1.5 %) |
Coronary flow reserve and echocardiography
Coronary flow reserve | VO2PeakFFM | |||||||
---|---|---|---|---|---|---|---|---|
Low (CFR ≤ 2.28) | High (CFR > 2.28) | Low (VO2PeakFFM ≤ 126.5) | High (VO2PeakFFM >126.5) | |||||
n = 32 | n = 33 | n = 32 | n = 33 | |||||
Patient characteristics | ||||||||
Age | 64 | (59–68) | 62 | (56–67) | 65 | (61–69) | 62 | (55–65)* |
Male sex | 26 | (81.3 %) | 28 | (84.9 %) | 24 | (75.0 %) | 30 | (90.9 %) |
CABG/PCI involving LAD | 16 | (50.0 %) | 20 | (60.0 %) | 19 | (59.4 %) | 17 | (51.5 %) |
ACE–inhibitors | 16 | (50.0 %) | 13 | (39.4 %) | 16 | (50.0 %) | 13 | (39.4 %) |
Beta–blockers | 17 | (53.1 %) | 17 | (51.5 %) | 17 | (53.1 %) | 17 | (51.5 %) |
Echocardiography | ||||||||
Left ventricular ejection fraction (%) | 53 | (45–59) | 56 | (48–60) | 54 | (46–58) | 55 | (47–61) |
End diastolic volume (mL/m2) | 38.4 | (34.4–50.5) | 40.8 | (34.5–47.7) | 36.0 | (31.3–39.6) | 43.6 | (39.2–54.1)* |
End systolic volume (mL/m2) | 17.6 | (15.0–26.6) | 17.7 | (14.2–24.3) | 16.4 | (13.8–22.0) | 18.5 | (15.6–27.0)* |
Coronary flow reserve (ratio) | 1.91 | (1.77–2.09) | 2.62 | (2.53–2.97)* | 2.13 | (1.87–2.55) | 2.52 | (2.07–2.71)* |
Exercise capacity | ||||||||
VO2peakBW (ml/min/kg) | 18.3 | (16.5–21.9) | 23.2 | (20.5–27.3)* | 17.7 | (16.0–20.5) | 25.1 | (22.3–27.6)* |
VO2peakFFM (ml/min/kg FFM(2/3)) | 116.0 | (104.0–129.9) | 135.5 | (121.6–161.9)* | 108.7 | (98.4–119.6) | 145.6 | (133.1–162.7)* |
Respiratory exchange ratio (RER) | 1.21 | (1.16–1.28) | 1.19 | (1.15–1.22) | 1.21 | (1.15–1.28) | 1.18 | (1.15–1.23) |
Glucose metabolism | ||||||||
Insulin sensitivity (ISIcomposite) | 2.21 | (1.71–3.50) | 2.49 | (1.76–3.59) | 2.28 | (1.88–3.35) | 2.48 | (1.66–3.77) |
Insulin sensitivity (ISIHOMA) | 0.28 | (0.19–0.46) | 0.31 | (0.22–0.46) | 0.28 | (0.19–0.45) | 0.30 | (0.22–0.48) |
Hba1c (%) | 5.9 | (5.7–6.1) | 5.9 | (5.5–6.2) | 6.1 | (5.9–6.3) | 5.8 | (5.5–6.0)* |
Fasting plasma glucose (mmol/L) | 5.88 | (5.31–6.33) | 5.85 | (5.65–6.18) | 6.07 | (5.70–6.33) | 5.73 | (5.46–6.07)* |
Fasting plasma insulin (pmol/L) | 100 | (60–131) | 88 | (56–120) | 94 | (60–124) | 93 | (61–121) |
Glucose tolerance (2 h-PG) (mmol/L) | 7.95 | (6.31–9.49) | 7.37 | (5.91–8.86) | 8.14 | (6.47–9.66) | 7.17 | (5.64–8.85) |
Beta cell function (Btotal) (nL/kg/min) | 1.90 | (1.46–2.37) | 1.93 | (1.46–2.86) | 1.85 | (1.45–2.37) | 1.99 | (1.46–2.71) |
β-cell function adjusted for insulin sensitivity (Di) | 4.89 | (2.82–8.12) | 5.52 | (3.18–7.45) | 5.48 | (3.06–8.98) | 4.64 | (2.82–7.17) |
Body composition | ||||||||
BMI (kg/m2) | 31.1 | (29.5–35.1) | 31.5 | (29.9–33.3) | 31.0 | (29.5–33.2) | 31.8 | (29.9–33.7) |
Waist-to-hip-ratio | 1.00 | (0.98–1.03) | 1.01 | (0.97–1.04) | 1.00 | (0.96–1.05) | 1.00 | (0.97–1.03) |
Body fat (%) | 35.7 | (32.6–41.0) | 32.2 | (29.1–35.7)* | 34.3 | (31.0–42.1) | 33.4 | (30.5–35.8) |
Visceral fat (mm3) | 293 | (260–332)(n = 14) | 276 | (211–316)(n = 23) | 293 | (222–345)(n = 16) | 280 | (211–297)(n = 21) |
Central-to-peripheral fat ratio | 1.52 | (1.34–1.70) | 1.65 | (1.39–2.05) | 1.54 | (1.34–1.82) | 1.59 | (1.39–1.89) |
Univariate correlations | ||||
---|---|---|---|---|
Coronary flow reserve | VO2PeakFFM | |||
r | p-value | r | p-value | |
Age | −0.13 | 0.30 | −0.38 | 0.0015 |
Echocardiography | ||||
Left ventricular ejection fraction (%) | 0.20 | 0.10 | 0.33 | 0.008 |
End diastolic volume (mL/m2) | −0.06 | 0.61 | 0.32 | 0.01 |
End systolic volume (mL/m2) | −0.10 | 0.44 | 0.13 | 0.30 |
Coronary flow reserve (ratio) | - | - | 0.41 | 0.0007 |
Exercise capacity | ||||
VO2peakFFM (ml/min/kg FFM(2/3)) | 0.41 | 0.0007 | - | - |
Respiratory exchange ratio (ratio) | −0.17 | 0.17 | −0.08 | 0.52 |
Glucose metabolism | ||||
Insulin sensitivity (ISIcomposite) | 0.04 | 0.73 | 0.08 | 0.53 |
Insulin sensitivity (ISIHOMA) | 0.06 | 0.65 | 0.16 | 0.18 |
Hba1c (%) | 0.03 | 0.79 | −0.30 | 0.014 |
Fasting plasma glucose (mmol/L) | −0.06 | 0.64 | −0.22 | 0.08 |
Fasting plasma insulin (pmol/L) | −0.16 | 0.20 | −0.10 | 0.46 |
Glucose tolerance (2 h-PG) (mmol/L) | −0.20 | 0.09 | −0.20 | 0.10 |
Beta cell function - Btotal (nL/kg/min) | 0.11 | 0.36 | −0.03 | 0.84 |
β-cell function adjusted for insulin sensitivity (Di) | 0.23 | 0.07 | 0.08 | 0.56 |
Body composition | ||||
BMI (kg/m2) | −0.15 | 0.22 | −0.05 | 0.67 |
Waist-to-hip-ratio | 0.07 | 0.59 | 0.02 | 0.88 |
Body fat (%) | −0.21 | 0.09 | −0.29 | 0.02 |
Visceral fat (mm3) (n = 37) | −0.22 | 0.17 | −0.28 | 0.10 |
Central-to-peripheral fat ratio | 0.13 | 0.30 | −0.18 | 0.16 |
Exercise capacity
VO2peakFFM | VO2peakBW | ||||
---|---|---|---|---|---|
SC | p-value | SC | p-value | ||
Age | −0.14 | 0.204 | Age | −0.08 | 0.370 |
Male sex | 0.17 | 0.226 | Male sex | 0.01 | 0.901 |
Body fat % | −0.01 | 0.951 | Body fat % | −0.40 | 0.002 |
Coronary flow reserve (ratio) | 0.32 | 0.003 | Coronary flow reserve (ratio) | 0.29 | 0.002 |
Left ventricular ejection fraction (%) | 0.37 | 0.001 | Left ventricular ejection fraction (%) | 0.32 | 0.001 |
Left ventricular end diastolic volume (mL/m2) | 0.33 | 0.005 | Left ventricular end diastolic volume (mL/m2) | 0.29 | 0.005 |
Hb1ac (%) | −0.18 | 0.075 | Hb1ac (%) | −0.17 | 0.063 |