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HIIT Improves Left Ventricular Exercise Response in Adults with Type 2 Diabetes

WILSON, GENEVIEVE A.1; WILKINS, GERARD T.1; COTTER, JIM D.2; LAMBERTS, REGIS R.3; LAL, SUDISH1; BALDI, JAMES C.1

Medicine & Science in Sports & Exercise: June 2019 - Volume 51 - Issue 6 - p 1099–1105
doi: 10.1249/MSS.0000000000001897
CLINICAL SCIENCES
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Type 2 diabetes is associated with reduced left ventricular reserve. It is unclear whether exercise training improves left ventricular function in people with type 2 diabetes.

Purpose This study aimed to determine whether 3 months of high-intensity interval training (HIIT) improves left ventricular function during exercise in adults with type 2 diabetes.

Methods Participants performed a V˙O2peak test and received a DXA scan and total blood volume measurement at baseline. Left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), and left ventricular stroke volume (LVSV) were then measured at rest and during low- and moderate-intensity semirecumbent exercise in adults with type 2 diabetes before and after 3 months of HIIT (n = 11) or no training (control) (n = 5). The effects of HIIT were determined using repeated-measures ANOVA.

Results HIIT increased V˙O2peak by approximately 15% (P < 0.002) but did not change body composition or total blood volume. LVESV decreased and LVEDV and LVSV increased from rest to moderate-intensity exercise in both groups at baseline (all P < 0.01). Three months of HIIT increased LVEDV (P = 0.008) and LVSV (P = 0.02) at all conditions, but there was no difference in controls (all P > 0.05). HIIT augmented the reduction in LVESV from rest to moderate-intensity exercise (P < 0.04), but LVESV was unchanged in controls. Increased LVEDV explained 51% of the change in LVSV after HIIT intervention. Mitral inflow parameters and mitral annular velocities were unaffected by HIIT (all P > 0.05).

Conclusions HIIT training increased the LVSV response to exercise in adults with type 2 diabetes. These data suggest that HIIT can improve LV filling and emptying during exercise and reverse early cardiac consequences of type 2 diabetes.

1Department of Medicine, University of Otago, Dunedin, NEW ZEALAND;

2School of Physical Education, Sports and Exercises Sciences, University of Otago, Dunedin, NEW ZEALAND; and

3Department of Physiology, School of Biomedical Sciences, HeartOtago, University of Otago, Dunedin, NEW ZEALAND

Address for correspondence: James Christopher Baldi, Ph.D., Department of Medicine, Dunedin Hospital, 9th Floor, Great King Street, Dunedin 9016, New Zealand; E-mail: Chris.baldi@otago.ac.nz.

Submitted for publication August 2018.

Accepted for publication December 2018.

© 2019 American College of Sports Medicine