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May 7, 2009Heart

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).

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Why the study?

Does a 1-year exercise intervention improve myocardial function in patients with type 2 diabetes mellitus without occult coronary artery disease?

Population

223 patients with type 2 diabetes mellitus (T2DM) without occult coronary artery disease, aged 18-75 years.

Comparison

1-year exercise intervention consisting of gym… vs Usual care.

Design

RCT, Randomised to an exercise training group or a usual care group

Follow-up

1 year

Authors

MHM. HordernJCJeff S. CoombesLCLeo M. Cooney

Discussion

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Overview

Exercise improves metabolic parameters and capacity in T2DM but not myocardial function; challenges presumed direct cardiac benefits of lifestyle intervention.

Key Points

  • To assess the effects of a 1-year exercise intervention on myocardial dysfunction in patients with type 2 diabetes mellitus.
  • Randomized controlled trial (Diabetes Lifestyle Intervention Study; ACTRN12607000060448) at a university hospital involving 223 patients with type 2 diabetes aged 18–75 without occult coronary artery disease.
  • Participants were assigned to an exercise intervention group (n = 111; gym sessions followed by telephone-monitored home exercise) or usual care (n = 112), with complete 1-year follow-up data available for 176 patients (88 per group).
  • Myocardial function was evaluated via tissue Doppler-derived myocardial velocities, strain, and strain-rate, alongside metabolic markers, body composition, and VO2max.
  • Overall changes in myocardial function did not differ significantly between the exercise group and usual care, despite significant improvements in waist circumference, fat mass, blood glucose, HbA1c, insulin sensitivity, VO2max, and 6-minute walk distance in the intervention arm (all p < 0.05).
  • In post-hoc analyses, intervention participants who engaged in the most moderate-to-vigorous physical activity achieved significant improvements in myocardial tissue velocity (p < 0.01), HbA1c (p = 0.03), and VO2max (p = 0.03) compared to controls.
  • Intervention participants with the largest increase in moderate activity showed significant improvements in myocardial strain rate (p = 0.03) and HbA1c (p = 0.03).

Structured PICO

Does a 1-year exercise intervention improve myocardial function in patients with type 2 diabetes mellitus without occult coronary artery disease?

P
Population
223 patients with type 2 diabetes mellitus (T2DM) without occult coronary artery disease, aged 18-75 years.
I
Intervention
1-year exercise intervention consisting of gym training followed by telephone-monitored home-based exercise training.
C
Comparator
Usual care.
O
Outcome
Tissue Doppler-derived myocardial velocities, strain-rate and strain, body composition, glycated haemoglobin (HbA1c), maximum oxygen consumption (VO2max) and physical activity at 1 year.surrogate

A 1-year exercise intervention in patients with T2DM improved metabolic function and exercise capacity but did not significantly improve overall myocardial function.

Cite This Study

Hordern et al. (2009) studied this question.

synapsesocial.com/papers/6a851398ca95d8503fe592bbhttps://doi.org/10.1136/hrt.2009.165571
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Exercise training does not improve myocardial diastolic tissue velocities in Type 2 diabetes2007 · 50 citations
  2. 2Meta-analysis of the effects of different exercise modes on cardiac function and peak oxygen uptake in patients with type 2 diabetes mellitus2024 · 4 citations
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  4. 4Effects of exercise on cardiac structure and function in patients with type 2 diabetes: a narrative review of prospective imaging studies2025 · 2 citations
  5. 5Effect of Exercise Intervention on Endothelial Function and Incidence of Cardiovascular Disease in Patients with Type 2 Diabetes2010 · 137 citations