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Normalization of Diastolic Dysfunction in Type 2 Diabetics after Exercise Training

BRASSARD, PATRICE; LEGAULT, SYLVIE; GARNEAU, CAROLINE; BOGATY, PETER; DUMESNIL, JEAN-GASTON; POIRIER, PAUL

Medicine & Science in Sports & Exercise: November 2007 - Volume 39 - Issue 11 - pp 1896-1901
doi: 10.1249/mss.0b013e318145b642
CLINICAL SCIENCES: Clinical Investigations

Purpose: The purpose of this study was to evaluate the impact of aerobic exercise training on left ventricular diastolic dysfunction (LVDD) and exercise capacity in subjects with type 2 diabetes.

Methods: Twenty-three sedentary subjects with well-controlled type 2 diabetes, free of coronary disease and having different degrees of LVDD, participated in the study. Subjects were treated with oral hypoglycemic agents and/or diet. Eleven subjects (EX) (age: 58 ± 5 yr; mean ± SD) underwent a 3-month aerobic exercise training program using a cycle ergometer, whereas a control group (CONT) of 12 subjects (57 ± 6 yr) maintained their activities of daily living. Exercise capacity and LVDD, using echocardiography, were evaluated before and after the 3-month exercise program.

Results: At baseline, anthropometric data were similar between the groups, except for body mass index (BMI), which was higher in CONT (31 ± 3 vs28± 3 kg·m−2; P < 0.05). There were no significant differences in glycemic control (HbA1c: 6.4 ± 1.2 vs 5.8 ± 1.3%; P = 0.2) or maximal oxygen uptake (26.7 ± 5.9 vs 28.6 ± 3.9 mL·kg−1·min−1; P = 0.4) between groups. Normalization of LVDD was observed in 5 of 11 EX subjects, (P < 0.0001) of whom four had grade 1 LVDD before exercise training. No change in diastolic function was observed in the CONT group. After exercise training, maximal oxygen uptake increased in the EX group (28.6 ± 3.9 vs 32.7 ± 5.7 mL·kg−1·min−1; P < 0.05), whereas there was no change in the CONT group (26.7 ± 5.9 vs 27.3 ± 6.2 mL·kg−1·min−1; P = 0.58). In both groups, there was no significant change in BMI.

Conclusions: Along with an improvement in exercise capacity, aerobic exercise training has the potential to reverse LVDD in patients with well-controlled, uncomplicated type 2 diabetes.

Laval Hospital Research Center, Quebec Heart and Lung Institute, Quebec, CANADA

Address for correspondence: Dr. Paul Poirier, M.D., Ph.D., Institut universitaire de cardiologie et de pneumologie, Centre de recherche clinique/Hôpital Laval, 2725 chemin Ste-Foy, Sainte-Foy, Québec, G1V 4G5, Canada; E-mail: paul.poirier@crhl.ulaval.ca.

Submitted for publication May 2007.

Accepted for publication June 2007.

©2007The American College of Sports Medicine