Search

Background: The goal was studying the differential effects of aerobic training (AT) vs. resistance training (RT) on cardiac and peripheral arterial capacity on cardiopulmonary (CP) and peripheral vascular (PV) function in sedentary and obese adults.Methods: In a prospective randomized controlled trial, we studied the effects of 6 months of AT vs. RT in 21 subjects. Testing included cardiac and vascular ultrasoundography and serial CP for ventricular-arterial coupling (Ees/Ea), strain-based variables, brachial artery flow-mediated dilation (BAFMD), and peak VO2 (pVO2; mL/kg/min) and peak O2-pulse (O2p; mL/beat).Results: Within the AT group (n = 11), there were significant increases in rVO2 of 4.2 mL/kg/min (SD 0.93) (p = 0.001); O2p of 1.9 mL/beat (SD 1.3) (p = 0.008) and the brachial artery post-hyperemia peak diameter 0.18 mm (SD 0.08) (p = 0.05). Within the RT group (n = 10) there was a significant increase in left ventricular end diastolic volume 7.0 mL (SD 9.8; p = 0.05) and percent flow-mediated dilation (1.8%) (SD 0.47) (p = 0.004). Comparing the AT and RT groups, post exercise, rVO2 2.97, (SD 1.22), (p = 0.03), O2p 0.01 (SD 1.3), (p = 0.01), peak hyperemic blood flow volume (1.77 mL) (SD 140.69) (p = 0.009), were higher in AT, but LVEDP 115 mL (SD 7.0) (p = 0.05) and Ees/Ea 0.68 mmHg/ml (SD 0.60) p = 0.03 were higher in RT.Discussion: The differential effects of AT and RT in this hypothesis generating study have important implications for exercise modality and clinical endpoints.

The use of speckle-tracking echocardiography (STE) is becoming an increasingly useful tool in the evaluation of myocardial disease. STE software can track the motion of the specular pattern created by the interference of ultrasound with the myofibers of the heart and provide a quantitative means to evaluate subtle changes in ventricular function that often occur before changes in ventricular ejection fraction are observed. STE is most often used to measure the change in shape (strain) of myocardial segments in the circumferential, radial, and longitudinal directions. In various diseases, including coronary artery disease, aortic stenosis, and mitral regurgitation, deficits in longitudinal strain appear to occur earlier than deficits in other measures of strain or in ejection fraction. Consideration of STE measures of left ventricular contraction has the potential to significantly affect clinical management and outcomes of ischemic and valvular heart disease given the ability to separate those with asymptomatic disease who may benefit from earlier interventions than current guidelines may suggest.

Background/aim Diabetic cardiomyopathy is defined as left ventricular dysfunction that occurs independently of coronary artery disease, and hypertension. The aim of this study is to investigate early alterations in left ventricular systolic and diastolic functions in patients with type 2 diabetes mellitus using strain and strain rate Echo compared with normal subjects. Patients and methods he present study enrolled forty subjects. They were divided into two groups: Group (1): Patients with only type 2 diabetes mellitus (20 Patients).Group (2) Normal Subjects as controls (20 Patients).All patients of type 2 diabetes mellitus according to the WHO criteria treated with oral hypo glycemic drugs. Mean age of diabetic group is (53.05 ± 7.02). All the studied groups were subjected to: full history taking and clinical examination, resting 12 leads surface electro-cardiogram, laboratory assessment of Glycosylated Hb, standard trans-thoracic echocardiography, tissue Doppler imaging, strain and strain rate imaging. Results All of the groups investigated did not differ in EF%, FS, decleration time, isovolumetric relaxation time, E/A ratio. Deterioration of left ventricular systolic and diastolic functions was evident in diabetic group, which was indicated by TDI parameters (significantly lower values of Sm, Em and Em-to-Am ratio). Systolic strain, peak systolic strain rate early and late diastolic strain were significantly lower in patients with type 2 diabetes than in controls. Conclusion Type 2 diabetes mellitus deteriorate both LV systolic and diastolic performance. Strain and strain rate by tissue Doppler Imaging is superior to conventional Doppler in early detection and evaluation of systolic and diastolic dysfunction in type 2 diabetic patients.

Recent developments in echocardiographic imaging technology and processing enabled the quantification of myocardial motion and deformation in a clinical setting. Echocardiographic strain (-rate) imaging provides a relatively easy way to study myocardial deformation. However, although (local) deformation is clearly linked to cardiac (dys-) function, it is important to understand how this information can be used in clinical practice and how specific deformation patterns should be interpreted. This review paper first discusses which issues are important to address when assessing cardiac function and how (regional) deformation and myocardial contractility are related. The use and interpretation of deformation profiles is further illustrated for some typical cardiac pathologies. The observed deformation patterns are discussed in light of the changes in regional contractility (ischemia), timing of contractile force development (LBBB and heart failure), pressure/volume overload, and assessing diastolic function.