Abstract 13935: Regular Physical Exercise Training Improves Diastolic Function in Pre-Diabetic, Adipose Patients With Coronary Artery Disease
Glycosylation of structural myocardial proteins is thought to play a role in the development of diastolic dysfunction (DD) in diabetic patients. Moreover, many obese patients -although not diabetic yet- are characterized by an impaired glucose tolerance with intermittent peaks in blood sugar levels. However, nothing is known so far about the occurrence of DD in patients with impaired glucose tolerance (IGT) and whether DD is influenced by regular physical exercise training, which probably normalizes glucose levels. Therefore, aim of our study was to elucidate the influence of 4 weeks of ET on IGT and diastolic function in obese patients with coronary artery disease (CAD) and IGT.
Methods: 62 obese patients with CAD and IGT were randomized to 4 weeks of ET (6 times a day on a bicycle and rowing ergometer) or sedentary lifestyle (C). At begin and after 4 weeks an echocardiography was performed to assess diastolic function. Mitral inflow was measured by pulsed-wave (PW) Doppler, including the peak early filling (E-wave) and late diastolic filling (A-wave) velocities, the E/A ratio, deceleration time (DT) of early filling velocity and the isovolumetric relaxation time.
Results: Regular physical exercise training was associated with a normalization of glucose tolerance. E-wave increased significantly by +14% from 0.65±0.02 m/s to 0.74±0.03 m/s (p<0.05 for delta vs. C). In contrast, A-wave remained virtually unchanged after 4 weeks of ET. This resulted in a rise in E/A ratio by +24% from 0.94±0.04 to 1.16±0.06 in patients of the training group (p<0.05 for delta vs. C). Moreover, ET resulted in a significant change in IVRT by −19% from 108.8±2.9 ms to 88.4±3.4 ms (p<0.05 for delta vs. C) and DT by −10% from 213.6±6.7 ms to 192.3±7.4 ms (p<0.05 for delta vs. C). All above mentioned parameters remained virtually unchanged in the control group. Moreover, no change was detectable in both groups in systolic left-ventricular function, left-ventricular diameter and wall thickness.
Conclusion: In obese CAD patients with impaired glucose tolerance regular physical exercise training improves diastolic function assessed by echocardiography. This might be partially the result of a reduced glycosylation of myocardial proteins due to a normalization of glucose tolerance.
- © 2011 by American Heart Association, Inc.