TY - JOUR
T1 - Altered hemodynamics during muscle metaboreflex in young type 1 diabetes patients
AU - Roberto, Silvana
AU - Marongiu, Elisabetta
AU - Pinna, Marco
AU - Angius, Luca
AU - Olla, Sergio
AU - Bassareo, Pierpaolo
AU - Tocco, Filippo
AU - Concu, Alberto
AU - Milia, Raffaele
AU - Crisafulli, Antonio
PY - 2012/10/15
Y1 - 2012/10/15
N2 - A reduction in catecholamine levels during exercise has been described in young subjects with type 1 diabetes mellitus (DM1). It has been suggested that type 1 diabetes per se is associated with the loss of sympathetic response before any clinical evidence. Considering that an increase in sympathetic drive is required for normal cardiovascular response to muscle metaboreflex, the aim of this study was to assess the hemodynamics during metaboreflex in DM1 patients. Impedance cardiography was used to measure hemodynamics during metaboreflex activation, obtained through postexercise ischemia in 14 DM1 patients and in 11 healthy controls (CTL). Principal results were: 1) blunted blood pressure response during metaboreflex was observed in DM1 patients compared with the CTL; 2) reduced capacity to increase systemic vascular resistance was also witnessed in DM1 subjects; 3) DM1 subjects reported higher stroke volumes as a consequence of reduced cardiac afterload compared with the CTL, which led to a more evident cardiac output response, which partially compensated for the lack of vasoconstriction. These facts suggest that cardiovascular regulation was altered in DM1 patients and that there was a reduced capacity to increase sympathetic tone, even in the absence of any overt clinical sign. The metaboreflex test appears to be a valid tool to detect early signs of this cardiovascular dysregulation.
AB - A reduction in catecholamine levels during exercise has been described in young subjects with type 1 diabetes mellitus (DM1). It has been suggested that type 1 diabetes per se is associated with the loss of sympathetic response before any clinical evidence. Considering that an increase in sympathetic drive is required for normal cardiovascular response to muscle metaboreflex, the aim of this study was to assess the hemodynamics during metaboreflex in DM1 patients. Impedance cardiography was used to measure hemodynamics during metaboreflex activation, obtained through postexercise ischemia in 14 DM1 patients and in 11 healthy controls (CTL). Principal results were: 1) blunted blood pressure response during metaboreflex was observed in DM1 patients compared with the CTL; 2) reduced capacity to increase systemic vascular resistance was also witnessed in DM1 subjects; 3) DM1 subjects reported higher stroke volumes as a consequence of reduced cardiac afterload compared with the CTL, which led to a more evident cardiac output response, which partially compensated for the lack of vasoconstriction. These facts suggest that cardiovascular regulation was altered in DM1 patients and that there was a reduced capacity to increase sympathetic tone, even in the absence of any overt clinical sign. The metaboreflex test appears to be a valid tool to detect early signs of this cardiovascular dysregulation.
KW - Adult
KW - Blood Pressure/physiology
KW - Cardiac Output/physiology
KW - Cardiography, Impedance/methods
KW - Cardiovascular System/physiopathology
KW - Diabetes Mellitus, Type 1/metabolism
KW - Exercise/physiology
KW - Female
KW - Heart Rate/physiology
KW - Hemodynamics/physiology
KW - Humans
KW - Ischemia/physiopathology
KW - Male
KW - Muscle, Skeletal/blood supply
KW - Myocardial Contraction/physiology
KW - Reflex/physiology
KW - Stroke Volume/physiology
KW - Sympathetic Nervous System/physiopathology
KW - Vascular Resistance/physiology
KW - Vasoconstriction/physiology
U2 - 10.1152/japplphysiol.00280.2012
DO - 10.1152/japplphysiol.00280.2012
M3 - Article
C2 - 22700802
SN - 8750-7587
VL - 113
SP - 1323
EP - 1331
JO - Journal of Applied Physiology
JF - Journal of Applied Physiology
IS - 8
ER -