Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2007 Sep 26:5:32.
doi: 10.1186/1476-7120-5-32.

Exercise training does not improve myocardial diastolic tissue velocities in Type 2 diabetes

Antti Loimaala  1 , Kaj Groundstroem, Marjo Rinne, Arja Nenonen, Heini Huhtala, Ilkka Vuori
Affiliations
Randomized Controlled Trial

Exercise training does not improve myocardial diastolic tissue velocities in Type 2 diabetes

Antti Loimaala et al. Cardiovasc Ultrasound. .

Abstract

Background: Myocardial diastolic tissue velocities are reduced already in newly onset Type 2 diabetes mellitus (T2D). Poor disease control may lead to left ventricular (LV) systolic dysfunction and heart failure. The aim of this study was to assess the effects of exercise training on myocardial diastolic function in T2D patients without ischemic heart disease.

Methods: 48 men (52.3 +/- 5.6 yrs) with T2D were randomized to supervised training four times a week and standard therapy (E), or standard treatment alone (C) for 12 months. Glycated hemoglobin (HbA1c), oxygen consumption (VO2max), and muscle strength (Sit-up) were measured. Tissue Doppler Imaging (TDI) was used to determine the average maximal mitral annular early (Ea) and late (Aa) diastolic as well as systolic (Sa) velocities, systolic strain (epsilon) and strain rate (epsilon) from the septum, and an estimation of left ventricular end diastolic pressure (E/Ea).

Results: Exercise capacity (VO2max, E 32.0 to 34.7 vs. C 32.6 to 31.5 ml/kg/min, p = .001), muscle strength (E 12.7 to 18.3 times vs. C 14.6 to 14.7 times, p < .001), and HbA1c (E 8.2 to 7.5% vs. C 8.0 to 8.4%, p = .006) improved significantly in the exercise group compared to the controls (ANOVA). Systolic blood pressure decreased in the E group (E 144 to 138 mmHg vs. C 146 to 144 mmHg, p = .04). Contrary to risk factor changes diastolic long axis relaxation did not improve significantly, early diastolic velocity Ea from 8.1 to 7.9 cm/s for the E group vs. C 7.4 to 7.8 cm/s (p = .85, ANOVA). Likewise, after 12 months the mitral annular systolic velocity, systolic strain and strain rate, as well as E/Ea were unchanged.

Conclusion: Exercise training improves endurance and muscle fitness in T2D, resulting in better glycemic control and reduced blood pressure. However, myocardial diastolic tissue velocities did not change significantly. Our data suggest that a much longer exercise intervention may be needed in order to reverse diastolic impairment in diabetics, if at all possible.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Mean peak mitral annular long-axis tissue doppler velocities (cm/s) in the study groups at baseline and after 12 months. Values are means (SE).
Figure 2
Figure 2
Maximal systolic strain (%) from the septum.
Figure 3
Figure 3
Maximal systolic strain rate (1/s) from the septum.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Burchfiel CM, Reed DM, Marcus EB, Strong JP, Hayashi T. Association of diabetes mellitus with coronary aterosclerosis and myocardial lesions: an autopsy study from the Honolulu Heart Program. Am J Epidemiol. 1993;137:1328–1340. - PubMed
    1. Uusitupa M, Mustonen JN, Airaksinen KE. Diabetic heart muscle disease. Ann Med. 1990;22:377–386. - PubMed
    1. The Diabetes Control and Complications Trial Research Group The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin dependent diabetes mellitus. N Engl J Med. 1993;329:977–986. doi: 10.1056/NEJM199309303291401. - DOI - PubMed
    1. Rubler S, Dlugash J, Yeceoglu YZ, Kumral T, Branwood AW, Grishman A. New type of cardiomyopathy associated with diabetic glomerulosclerosis. Am J Cardiol. 1972;30:595–602. doi: 10.1016/0002-9149(72)90595-4. - DOI - PubMed
    1. Loimaala A, Groundstroem K, Majahalme S, Nenonen A, Vuori I. Impaired myocardial function in newly onset Type 2 diabetes associates with arterial stiffness. Eur J Echocardiography. 2006;7:341–347. doi: 10.1016/j.euje.2005.07.001. - DOI - PubMed

Publication types