Effects of oral amino acid supplementation on myocardial function in patients with type 2 diabetes mellitus |
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Authors: | Scognamiglio Roldano Negut Christian Piccolotto Roberto Dioguardi Francesco Saverio Tiengo Antonio Avogaro Angelo |
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Institution: | a Division of Cardiology, Department of Clinical and Experimental Medicine, University of Padova Medical School, Padova, Italy c Division of Metabolic Diseases, Department of Clinical and Experimental Medicine, University of Padova Medical School, Padova, Italy b Division of Medicine, University of Milan Medical School, Milan, Italy |
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Abstract: | BackgroundDiabetes mellitus is associated with an increased rate of cardiac amino acid catabolism that could interfere with cardiac function.MethodsWe assessed the effects of an oral amino acids mixture (AAM) on myocardial function in patients with type 2 diabetes mellitus (DM2). We studied 65 consecutive patients with DM2 who had normal resting left ventricular ejection fraction (LVEF) and did not have obstructive coronary artery disease (CAD). After baseline evaluations, patients were randomized to receive, in a single-blinded fashion, AAM (12 grams/day) or placebo for 12 weeks, after which, treatment was crossed over for another similar period. At baseline and at the end of each treatment, 2-dimensional ecocardiography at rest and during isometric exercise (handgrip) was performed, as were biochemical assays. Twenty adults, matched for age, sex, and body mass index served as control subjects.ResultsAt baseline and during AAM or placebo treatment, resting left ventricular dimensions and LVEF in patients with DM2 did not differ from those of control subjects. In patients with DM2, at baseline and during placebo treatment, peak handgrip LVEF decreased significantly in comparison with the resting value (63% ± 9% vs 56% ± 9%, P <.001; and 62% ± 6% vs 55% ± 8%, P <.001). During AAM treatment, peak handgrip LVEF did not differ from resting value (66% ± 11% vs 64% ± 9%, P = not significant). Thus, exercise LVEF was higher during AAM treatment than both baseline and placebo treatment (66% ± 11% vs 56% ± 9% and vs 55% ± 8%, P <.001). In contrast to placebo treatment, after the AAM supply, a decreased glycated hemoglobin level was observed (7.0% ± 1.3% vs 7.6% ± 1.8%, P <.05).ConclusionsMyocardial dysfunction is easily inducible with isometric exercise in patients with DM2 who have normal resting LV function and do not have CAD. An increased amino acid supply prevents this phenomenon and improves metabolic control. |
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