Effects of exercise intervention on myocardial function in type 2 diabetes

Hordern, MD, Coombes, JS, Cooney, LM, Jeffriess, L, Prins, JB and Marwick, TH (2009) Effects of exercise intervention on myocardial function in type 2 diabetes. Heart, 95 16: 1343-1349. doi:10.1136/hrt.2009.165571


Author Hordern, MD
Coombes, JS
Cooney, LM
Jeffriess, L
Prins, JB
Marwick, TH
Title Effects of exercise intervention on myocardial function in type 2 diabetes
Journal name Heart   Check publisher's open access policy
ISSN 1355-6037
Publication date 2009-08-01
Year available 2009
Sub-type Article (original research)
DOI 10.1136/hrt.2009.165571
Open Access Status
Volume 95
Issue 16
Start page 1343
End page 1349
Total pages 7
Editor Timmis, A. D.
Place of publication United Kingdom
Publisher B M J Group
Language eng
Subject C1
970111 Expanding Knowledge in the Medical and Health Sciences
920104 Diabetes
111102 Dietetics and Nutrigenomics
110201 Cardiology (incl. Cardiovascular Diseases)
110306 Endocrinology
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 (HbA(1c)), 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, HbA(1c), 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), HbA(1c) (p = 0.03) and VO2max (p = 0.03) compared to controls. Myocardial strain rate (p = 0.03) and HbA(1c) 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.
Keyword INSULIN-RESISTANCE
DOPPLER-ECHOCARDIOGRAPHY
GLYCEMIC CONTROL
GLUCOSE CONTROL
HEART-FAILURE
CAPACITY
MELLITUS
DISEASE
COMPLICATIONS
DETERMINANTS
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
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Created: Thu, 03 Sep 2009, 17:46:03 EST by Mr Andrew Martlew on behalf of School of Medicine