Chulalongkorn Medical Journal


Background: A diabetes mellitus (DM) patients sometimes exhibit a pseudo-normal diastolic relaxation during echocardiography examination, which may lead to an incorrect diagnosis. Exercise echocardiography help uncover this hidden alteration, but conventional exercise techniques contain movement artifacts. Recently, an isotonic handgrip exercise was introduced and caused hemodynamic and diastolic changes with less movement. Objective: To investigate hemodynamic and left ventricular diastolic that responses to a dynamic handgrip exercise (DHE) in DM patients. Methods: 12 controls and 12 DM patients were recruited and evaluated for hemodynamic and diastolic functions at rest and 3 minutes after performing DHE. Results: DHE increased systolic blood pressure, A wave, and lateral e’ of all subjects. For DM, DHE increased E wave (0.67  0.16 m/s vs. 0.81  0.19 m/s, P = 0.006) and septal e’ (7.17  1.59 cm/s vs. 8.50  1.62 cm/s, P = 0.004). A significant reduction of DT was also observed in DM (178.00  40.24 ms vs.155.10  24.14 ms, P = 0.041). DHE caused negative changes of ΔE/A ratio in controls whereas positive in DM patients (- 0.20  0.21 vs. 0.06  0.18, P = 0.005). Conclusion: DHE induced increases of early diastole indices, E wave and e’, in DM. DHE displayed a feasibility for using as an exercise stressor during echocardiography.


Faculty of Medicine, Chulalongkorn University



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