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Effects of exercise intervention on myocardial function in type 2 diabetes
Citation
Hordern, MD and Coombes, JS and Cooney, LM and Jeffriess, L and Prins, JB and Marwick, TH, Effects of exercise intervention on myocardial function in type 2 diabetes, Heart, 95, (16) pp. 1343-1349. ISSN 1355-6037 (2009) [Refereed Article]
Copyright Statement
Copyright 2009 BMJ
DOI: doi:10.1136/hrt.2009.165571
Abstract
Objective: To identify the effects of a 1-year exercise
intervention on myocardial dysfunction in patients with
type 2 diabetes mellitus (T2DM).
Design: Randomised controlled trial, the Diabetes Lifestyle Intervention Study.
Setting: University hospital.
Patients: 223 T2DM patients without occult coronary artery disease, aged 18–75 were randomised to an exercise training group (n=111) or a usual care group (n=112). Complete follow-up data were available in 176 (88 exercise, 88 usual care).
Interventions: Exercise training consisted of gym, followed by telephone-monitored home-based exercise training.
Main outcome measures: Tissue Doppler-derived myocardial velocities, strain-rate and strain, body composition, glycated haemoglobin (HbA1c), maximum oxygen consumption (VO2max) and physical activity.
Results: Overall changes in myocardial function were not different between groups despite improvements in waist circumference, fat mass, blood glucose, HbA1c, insulin sensitivity, VO2max and 6-minute walk distance in the intervention group (p<0.05). The latter also spent significantly more time in vigorous activity (p<0.05). A post-hoc analysis revealed that intervention patients who spent more time in both moderate and vigorous activity showed a significant improvement in myocardial tissue velocity (p<0.01), HbA1c (p=0.03) and VO2max (p=0.03) compared to controls. Myocardial strain rate (p=0.03) and HbA1c improved in intervention patients with the greatest increase in moderate activity (p=0.03).
Conclusions: In patients with T2DM, current exercise recommendations led to an improvement in metabolic function, but failed to improve myocardial function in the overall group. Patients with greater increases in both moderate and vigorous activity showed improvements in myocardial function, glycaemic control and cardiorespiratory fitness.
Design: Randomised controlled trial, the Diabetes Lifestyle Intervention Study.
Setting: University hospital.
Patients: 223 T2DM patients without occult coronary artery disease, aged 18–75 were randomised to an exercise training group (n=111) or a usual care group (n=112). Complete follow-up data were available in 176 (88 exercise, 88 usual care).
Interventions: Exercise training consisted of gym, followed by telephone-monitored home-based exercise training.
Main outcome measures: Tissue Doppler-derived myocardial velocities, strain-rate and strain, body composition, glycated haemoglobin (HbA1c), maximum oxygen consumption (VO2max) and physical activity.
Results: Overall changes in myocardial function were not different between groups despite improvements in waist circumference, fat mass, blood glucose, HbA1c, insulin sensitivity, VO2max and 6-minute walk distance in the intervention group (p<0.05). The latter also spent significantly more time in vigorous activity (p<0.05). A post-hoc analysis revealed that intervention patients who spent more time in both moderate and vigorous activity showed a significant improvement in myocardial tissue velocity (p<0.01), HbA1c (p=0.03) and VO2max (p=0.03) compared to controls. Myocardial strain rate (p=0.03) and HbA1c improved in intervention patients with the greatest increase in moderate activity (p=0.03).
Conclusions: In patients with T2DM, current exercise recommendations led to an improvement in metabolic function, but failed to improve myocardial function in the overall group. Patients with greater increases in both moderate and vigorous activity showed improvements in myocardial function, glycaemic control and cardiorespiratory fitness.
Item Details
| Item Type: | Refereed Article |
|---|---|
| Research Division: | Biomedical and Clinical Sciences |
| Research Group: | Cardiovascular medicine and haematology |
| Research Field: | Cardiology (incl. cardiovascular diseases) |
| Objective Division: | Health |
| Objective Group: | Clinical health |
| Objective Field: | Clinical health not elsewhere classified |
| UTAS Author: | Marwick, TH (Professor Tom Marwick) |
| ID Code: | 90767 |
| Year Published: | 2009 |
| Web of Science® Times Cited: | 60 |
| Deposited By: | Menzies Institute for Medical Research |
| Deposited On: | 2014-04-23 |
| Last Modified: | 2014-05-22 |
| Downloads: | 0 |
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