P446 INDEPENDENT EFFECTS OF TYPE 2 DIABETES AND OBESITY ON CARDIOPULMONARY PERFORMANCE IN SUBJECTS AT HIGH CARDIOVASCULAR RISK

Abstract Background Both obesity and type 2 diabetes (T2D) are associated with effort intolerance heart failure. Since the two conditions often coexist overlap, their distinct effect on cardiopulmonary performance remains to be elucidated. Methods Patients at high cardiovascular risk, free from any clinical or instrumental evidence of disease, a wide range body mass index (BMI) values, without T2D underwent combined echocardiography–cardiopulmonary exercise test (eCPET). were divided in controls, as well lean (BMI <25 kg/m2), overweight 25 – 30 obese >30 kg/m2). Results A total 206 patients was analyzed, 109 97 controls. Increased BMI is multiple dysfunctions including chronotropic insufficiency, subclinical systolic dysfunction (reduced global longitudinal strain, GLS), impaired reserve, achieving significantly lower oxygen uptake workload. Obesity reduced lung volumes mild ventilatory alterations peak exercise, irrespective diabetes. showed more frequent LV concentric remodeling, worse diastolic rest diminished ameliorations during sympatho–vagal balance expressed by higher prevalence insufficiency delayed rate recovery. Nonetheless, when subclasses, differences between controls only evident among subjects. In fact, while no difference patients, individuals display than workload VO2peak, revealing (lower GLS) filling pressures (E/e’). Unlike glycated hemoglobin, strong linear relationships proven fat uptake, workload, systolic, indices. Conclusions affects dimensions geometry, systo–diastolic functions, autonomic balance, capacity, tolerance, independently presence obesity. increased an even powerful independent negative determinant function, tolerance. These early might partly explain risk developing failure