April 23, 2026Journal of the American College of Cardiology57 citations
View Full PaperEffects of Exercise Training on Myocardial Energy Metabolism and Ventricular Function Assessed by Quantitative Phosphorus-31 Magnetic Resonance Spectroscopy and Magnetic Resonance Imaging in Dilated Cardiomyopathy
Key Result
Exercise training in patients with dilated cardiomyopathy improved left ventricular ejection fraction (from 30% to 37%, p<0.01) without adversely affecting cardiac energy metabolism.
Key Points
- This study aims to evaluate the effects of exercise training on cardiac energy metabolism and ventricular function in dilated cardiomyopathy.
- Twenty-four patients randomized to exercise or control group, age 53 +/- 12 years and 56 +/- 6 years respectively.
- Supervised exercise training for 2 months, followed by 6 months of self-regulated training.
- Quantitative phosphorus-31 magnetic resonance spectroscopy and magnetic resonance imaging assessments conducted at baseline and 2 and 8 months.
- 17% increase in peak oxygen uptake after exercise training (p < 0.05).
- Improvement in left ventricular end-systolic volume and ejection fraction, with ejection fraction changing from 30 +/- 15% to 37 +/- 15% (p < 0.01).
- No changes in high-energy phosphate concentrations after training.
Study Design
Type
RCT (n=24)
Randomization
randomized
Structured PICO
Does exercise training improve cardiac energy metabolism and ventricular function in patients with dilated cardiomyopathy?
P
Population
24 patients with dilated cardiomyopathy (DCM), mean age 53 +/- 12 years (exercise group) and 56 +/- 6 years (control group).
I
Intervention
Supervised exercise training for 2 months, followed by 6 months of self-regulated training.
C
Comparator
Control group.
O
Outcome
Changes in cardiac energy metabolism and ventricular function assessed by quantitative phosphorus-31 magnetic resonance spectroscopy and magnetic resonance imaging at 2 and 8 months.surrogate
Exercise training in patients with dilated cardiomyopathy improves left ventricular function and exercise capacity without adversely affecting myocardial energy metabolism.
Main Result
p-value: p=<0.01
Abstract
OBJECTIVES: The present study investigated changes in cardiac energy metabolism and function in patients with dilated cardiomyopathy (DCM) before and after exercise training (ET) with phosphorus-31 magnetic resonance spectroscopy (MRS) in combination with magnetic resonance imaging (MRI). BACKGROUND: Exercise training might have a beneficial role on myocardial function and oxidative metabolism in DCM, but it is unclear whether the additional load on the failing heart leads to deterioration of cardiac energy metabolism. METHODS: Twenty-four patients were randomized to an exercise (age 53 +/- 12 years) or a control (age 56 +/- 6 years) group. Supervised ET was performed for 2 months, followed by 6 months of self-regulated training. At baseline and 2 and 8 months, maximal exercise testing along with quantitative MRS and MRI studies were performed. RESULTS: The effectiveness of ET was demonstrated by a 17% increase in peak oxygen uptake (p < 0.05). Exercise training improved left ventricular (LV) end-systolic volume (p < 0.05) and LV ejection fraction (30 +/- 15% vs. 37 +/- 15%; p < 0.01) but not right ventricular parameters. The improvement in cardiac function was not accompanied by changes in cardiac high-energy phosphate concentrations; phosphocreatine, adenosine triphosphate, and the phosphocreatine/adenosine triphosphate ratio were all unchanged after training. CONCLUSIONS: The observation that LV function improved and LV energy metabolism remained unchanged suggests that the beneficial effect of ET on LV function is achieved without adversely affecting metabolism. These findings lend further support for the use of ET as an adjunct therapy in DCM.