CPET variable | Alterations seen in T2D | Pathophysiologic mechanisms | Clinical value |
---|---|---|---|
Heart rate kinetics | Chronotropic insufficiency, Attenuated heart rate recovery | Autonomic neuropathy | Prognostic |
Exercise ECG | Eventual inducible ischemia | Epicardial vessel disease | Screening |
Exercise capacity | Reduced | Physical deconditioning? | Unknown |
Peak oxygen uptake (VO2max) | Reduced | Primary myocardial impairment | Prognostic |
Oxygen kinetics | Slower | Primary myocardial impairment | Unknown |
Oxygen pulse (VO2/HR) | Reduced | Primary myocardial impairment | Prognostic |
Ventilatoy response (VE/VCO2) | Augmented | Primary ventilatory impairment | Unknown |
Peripheral oxygen extraction (a-v O2) | Reduced | Skeletal muscle microcirculation impairment | Unknown |
Anaerobic threshold (AT) | Unaltered, even in the presence of autonomic dysfunction | Aerobic/anaerobic metabolism | Unknown |
VO2 at the anaerobic threshold (AT) | Possibly reduced | Unknown | Unknown |