Application of an exercise intervention on the evolution of diastolic dysfunction in patients with diabetes mellitus: efficacy and effectiveness
Diastolic dysfunction (DD) is associated with adverse cardiovascular outcomes. We studied the impact of an exercise-based lifestyle intervention on the evolution of DD in patients with type 2 diabetes mellitus (T2DM) and prospectively investigated the clinical correlates of DD progression. A total o...
Gespeichert in:
| Veröffentlicht in: | Circulation. Heart failure 2011-07, Vol.4 (4), p.441-449 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 449 |
|---|---|
| container_issue | 4 |
| container_start_page | 441 |
| container_title | Circulation. Heart failure |
| container_volume | 4 |
| creator | Hare, James L Hordern, Matthew D Leano, Rodel Stanton, Tony Prins, Johannes B Marwick, Thomas H |
| description | Diastolic dysfunction (DD) is associated with adverse cardiovascular outcomes. We studied the impact of an exercise-based lifestyle intervention on the evolution of DD in patients with type 2 diabetes mellitus (T2DM) and prospectively investigated the clinical correlates of DD progression.
A total of 223 outpatients with T2DM were randomized to supervised exercise-based lifestyle intervention (initial gym-based program and lifestyle and diet advice followed by telephone-guided supervision) or usual care. Patients underwent echocardiographic assessment of diastolic function and metabolic and clinical evaluation at baseline and 3 years. Changes in prevalence and evolution of DD were assessed and correlations sought with clinical and metabolic variables. DD was present in 50% of patients at baseline and 54% at 3 years, with no difference between the usual care and intervention groups (60% versus 48%, P=0.10). Abnormal DD at the final visit was independently associated with older age and a decrease in peak oxygen consumption over time (P |
| doi_str_mv | 10.1161/CIRCHEARTFAILURE.110.959312 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_878595889</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>878595889</sourcerecordid><originalsourceid>FETCH-LOGICAL-c262t-100a16b7cc5f923948bee5035d54a206dabafdca828a9d9e6961fae8c0c5a9aa3</originalsourceid><addsrcrecordid>eNpdkcFOAjEQhhujEURfwTTx4Gmx7dKl1RMhICQkJgTOm253GmqW3XXbRXkLH9kiwsFTpzP_N_8kP0IPlPQpTejTeL4czyaj5Wo6mi_Wy0nokr7kMqbsAnWpHNAoZnJ4ea6F7KAb594JSRjn8hp1GOXDhAnaRd-jui6sVt5WJa4MViWGL2i0dYBt6aHZQXmcldhvAMOuKtqTOLfK-SrgON8705b6d2BLXId9gXP40_rNQZaBB4e3UBTWt-4ZgzHBVO-DX374QECDEzh3i66MKhzc_b09tJ5OVuNZtHh7nY9Hi0izhPmIEqJokg215kayWA5EBsBJzHM-UIwkucqUybUSTCiZS0hkQo0CoYnmSioV99DjcW_dVB8tOJ9urdPhQFVC1bpUDAWXXAgZlC9HpW4q5xowad3YrWr2KSXpIZH0fyKhS9JjIoG-__Npsy3kZ_YUQfwDs8aOcg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>878595889</pqid></control><display><type>article</type><title>Application of an exercise intervention on the evolution of diastolic dysfunction in patients with diabetes mellitus: efficacy and effectiveness</title><source>MEDLINE</source><source>American Heart Association Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Hare, James L ; Hordern, Matthew D ; Leano, Rodel ; Stanton, Tony ; Prins, Johannes B ; Marwick, Thomas H</creator><creatorcontrib>Hare, James L ; Hordern, Matthew D ; Leano, Rodel ; Stanton, Tony ; Prins, Johannes B ; Marwick, Thomas H</creatorcontrib><description>Diastolic dysfunction (DD) is associated with adverse cardiovascular outcomes. We studied the impact of an exercise-based lifestyle intervention on the evolution of DD in patients with type 2 diabetes mellitus (T2DM) and prospectively investigated the clinical correlates of DD progression.
A total of 223 outpatients with T2DM were randomized to supervised exercise-based lifestyle intervention (initial gym-based program and lifestyle and diet advice followed by telephone-guided supervision) or usual care. Patients underwent echocardiographic assessment of diastolic function and metabolic and clinical evaluation at baseline and 3 years. Changes in prevalence and evolution of DD were assessed and correlations sought with clinical and metabolic variables. DD was present in 50% of patients at baseline and 54% at 3 years, with no difference between the usual care and intervention groups (60% versus 48%, P=0.10). Abnormal DD at the final visit was independently associated with older age and a decrease in peak oxygen consumption over time (P<0.05). There was no impact on glycemic control or exercise capacity. In a subanalysis restricted to patients who finished the full 3-year follow-up, control subjects were independently associated with DD at 3 years (β=0.90; odds ratio, 2.46; P=0.034), with the only other independent correlate being older age (β=0.05; odds ratio, 1.06; P=0.019).
Despite being efficacious in the subgroup who completed 3 years of exercise-based lifestyle intervention, randomization to this program was not effective in reducing progression of subclinical DD in patients with T2DM, which may reflect the recognized difficulty of adherence to prolonged exercise intervention.
URL: http://www.anzctr.org.au. Unique identifier: ACTRN12607000060448.</description><identifier>ISSN: 1941-3289</identifier><identifier>EISSN: 1941-3297</identifier><identifier>DOI: 10.1161/CIRCHEARTFAILURE.110.959312</identifier><identifier>PMID: 21576281</identifier><language>eng</language><publisher>United States</publisher><subject>Adult ; Aged ; Blood Glucose - metabolism ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - physiopathology ; Diabetes Mellitus, Type 2 - therapy ; Diastole - physiology ; Disease Progression ; Exercise Therapy ; Follow-Up Studies ; Humans ; Life Style ; Longitudinal Studies ; Male ; Middle Aged ; Oxygen Consumption - physiology ; Patient Compliance ; Prevalence ; Prospective Studies ; Risk Factors ; Treatment Outcome ; Ventricular Dysfunction, Left - epidemiology ; Ventricular Dysfunction, Left - metabolism ; Ventricular Dysfunction, Left - physiopathology</subject><ispartof>Circulation. Heart failure, 2011-07, Vol.4 (4), p.441-449</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c262t-100a16b7cc5f923948bee5035d54a206dabafdca828a9d9e6961fae8c0c5a9aa3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,3674,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21576281$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hare, James L</creatorcontrib><creatorcontrib>Hordern, Matthew D</creatorcontrib><creatorcontrib>Leano, Rodel</creatorcontrib><creatorcontrib>Stanton, Tony</creatorcontrib><creatorcontrib>Prins, Johannes B</creatorcontrib><creatorcontrib>Marwick, Thomas H</creatorcontrib><title>Application of an exercise intervention on the evolution of diastolic dysfunction in patients with diabetes mellitus: efficacy and effectiveness</title><title>Circulation. Heart failure</title><addtitle>Circ Heart Fail</addtitle><description>Diastolic dysfunction (DD) is associated with adverse cardiovascular outcomes. We studied the impact of an exercise-based lifestyle intervention on the evolution of DD in patients with type 2 diabetes mellitus (T2DM) and prospectively investigated the clinical correlates of DD progression.
A total of 223 outpatients with T2DM were randomized to supervised exercise-based lifestyle intervention (initial gym-based program and lifestyle and diet advice followed by telephone-guided supervision) or usual care. Patients underwent echocardiographic assessment of diastolic function and metabolic and clinical evaluation at baseline and 3 years. Changes in prevalence and evolution of DD were assessed and correlations sought with clinical and metabolic variables. DD was present in 50% of patients at baseline and 54% at 3 years, with no difference between the usual care and intervention groups (60% versus 48%, P=0.10). Abnormal DD at the final visit was independently associated with older age and a decrease in peak oxygen consumption over time (P<0.05). There was no impact on glycemic control or exercise capacity. In a subanalysis restricted to patients who finished the full 3-year follow-up, control subjects were independently associated with DD at 3 years (β=0.90; odds ratio, 2.46; P=0.034), with the only other independent correlate being older age (β=0.05; odds ratio, 1.06; P=0.019).
Despite being efficacious in the subgroup who completed 3 years of exercise-based lifestyle intervention, randomization to this program was not effective in reducing progression of subclinical DD in patients with T2DM, which may reflect the recognized difficulty of adherence to prolonged exercise intervention.
URL: http://www.anzctr.org.au. Unique identifier: ACTRN12607000060448.</description><subject>Adult</subject><subject>Aged</subject><subject>Blood Glucose - metabolism</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - physiopathology</subject><subject>Diabetes Mellitus, Type 2 - therapy</subject><subject>Diastole - physiology</subject><subject>Disease Progression</subject><subject>Exercise Therapy</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Life Style</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Oxygen Consumption - physiology</subject><subject>Patient Compliance</subject><subject>Prevalence</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Treatment Outcome</subject><subject>Ventricular Dysfunction, Left - epidemiology</subject><subject>Ventricular Dysfunction, Left - metabolism</subject><subject>Ventricular Dysfunction, Left - physiopathology</subject><issn>1941-3289</issn><issn>1941-3297</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkcFOAjEQhhujEURfwTTx4Gmx7dKl1RMhICQkJgTOm253GmqW3XXbRXkLH9kiwsFTpzP_N_8kP0IPlPQpTejTeL4czyaj5Wo6mi_Wy0nokr7kMqbsAnWpHNAoZnJ4ea6F7KAb594JSRjn8hp1GOXDhAnaRd-jui6sVt5WJa4MViWGL2i0dYBt6aHZQXmcldhvAMOuKtqTOLfK-SrgON8705b6d2BLXId9gXP40_rNQZaBB4e3UBTWt-4ZgzHBVO-DX374QECDEzh3i66MKhzc_b09tJ5OVuNZtHh7nY9Hi0izhPmIEqJokg215kayWA5EBsBJzHM-UIwkucqUybUSTCiZS0hkQo0CoYnmSioV99DjcW_dVB8tOJ9urdPhQFVC1bpUDAWXXAgZlC9HpW4q5xowad3YrWr2KSXpIZH0fyKhS9JjIoG-__Npsy3kZ_YUQfwDs8aOcg</recordid><startdate>201107</startdate><enddate>201107</enddate><creator>Hare, James L</creator><creator>Hordern, Matthew D</creator><creator>Leano, Rodel</creator><creator>Stanton, Tony</creator><creator>Prins, Johannes B</creator><creator>Marwick, Thomas H</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201107</creationdate><title>Application of an exercise intervention on the evolution of diastolic dysfunction in patients with diabetes mellitus: efficacy and effectiveness</title><author>Hare, James L ; Hordern, Matthew D ; Leano, Rodel ; Stanton, Tony ; Prins, Johannes B ; Marwick, Thomas H</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c262t-100a16b7cc5f923948bee5035d54a206dabafdca828a9d9e6961fae8c0c5a9aa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Blood Glucose - metabolism</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - physiopathology</topic><topic>Diabetes Mellitus, Type 2 - therapy</topic><topic>Diastole - physiology</topic><topic>Disease Progression</topic><topic>Exercise Therapy</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Life Style</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Oxygen Consumption - physiology</topic><topic>Patient Compliance</topic><topic>Prevalence</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>Treatment Outcome</topic><topic>Ventricular Dysfunction, Left - epidemiology</topic><topic>Ventricular Dysfunction, Left - metabolism</topic><topic>Ventricular Dysfunction, Left - physiopathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hare, James L</creatorcontrib><creatorcontrib>Hordern, Matthew D</creatorcontrib><creatorcontrib>Leano, Rodel</creatorcontrib><creatorcontrib>Stanton, Tony</creatorcontrib><creatorcontrib>Prins, Johannes B</creatorcontrib><creatorcontrib>Marwick, Thomas H</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation. Heart failure</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hare, James L</au><au>Hordern, Matthew D</au><au>Leano, Rodel</au><au>Stanton, Tony</au><au>Prins, Johannes B</au><au>Marwick, Thomas H</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Application of an exercise intervention on the evolution of diastolic dysfunction in patients with diabetes mellitus: efficacy and effectiveness</atitle><jtitle>Circulation. Heart failure</jtitle><addtitle>Circ Heart Fail</addtitle><date>2011-07</date><risdate>2011</risdate><volume>4</volume><issue>4</issue><spage>441</spage><epage>449</epage><pages>441-449</pages><issn>1941-3289</issn><eissn>1941-3297</eissn><abstract>Diastolic dysfunction (DD) is associated with adverse cardiovascular outcomes. We studied the impact of an exercise-based lifestyle intervention on the evolution of DD in patients with type 2 diabetes mellitus (T2DM) and prospectively investigated the clinical correlates of DD progression.
A total of 223 outpatients with T2DM were randomized to supervised exercise-based lifestyle intervention (initial gym-based program and lifestyle and diet advice followed by telephone-guided supervision) or usual care. Patients underwent echocardiographic assessment of diastolic function and metabolic and clinical evaluation at baseline and 3 years. Changes in prevalence and evolution of DD were assessed and correlations sought with clinical and metabolic variables. DD was present in 50% of patients at baseline and 54% at 3 years, with no difference between the usual care and intervention groups (60% versus 48%, P=0.10). Abnormal DD at the final visit was independently associated with older age and a decrease in peak oxygen consumption over time (P<0.05). There was no impact on glycemic control or exercise capacity. In a subanalysis restricted to patients who finished the full 3-year follow-up, control subjects were independently associated with DD at 3 years (β=0.90; odds ratio, 2.46; P=0.034), with the only other independent correlate being older age (β=0.05; odds ratio, 1.06; P=0.019).
Despite being efficacious in the subgroup who completed 3 years of exercise-based lifestyle intervention, randomization to this program was not effective in reducing progression of subclinical DD in patients with T2DM, which may reflect the recognized difficulty of adherence to prolonged exercise intervention.
URL: http://www.anzctr.org.au. Unique identifier: ACTRN12607000060448.</abstract><cop>United States</cop><pmid>21576281</pmid><doi>10.1161/CIRCHEARTFAILURE.110.959312</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1941-3289 |
| ispartof | Circulation. Heart failure, 2011-07, Vol.4 (4), p.441-449 |
| issn | 1941-3289 1941-3297 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_878595889 |
| source | MEDLINE; American Heart Association Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Adult Aged Blood Glucose - metabolism Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - physiopathology Diabetes Mellitus, Type 2 - therapy Diastole - physiology Disease Progression Exercise Therapy Follow-Up Studies Humans Life Style Longitudinal Studies Male Middle Aged Oxygen Consumption - physiology Patient Compliance Prevalence Prospective Studies Risk Factors Treatment Outcome Ventricular Dysfunction, Left - epidemiology Ventricular Dysfunction, Left - metabolism Ventricular Dysfunction, Left - physiopathology |
| title | Application of an exercise intervention on the evolution of diastolic dysfunction in patients with diabetes mellitus: efficacy and effectiveness |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-06T19%3A26%3A52IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Application%20of%20an%20exercise%20intervention%20on%20the%20evolution%20of%20diastolic%20dysfunction%20in%20patients%20with%20diabetes%20mellitus:%20efficacy%20and%20effectiveness&rft.jtitle=Circulation.%20Heart%20failure&rft.au=Hare,%20James%20L&rft.date=2011-07&rft.volume=4&rft.issue=4&rft.spage=441&rft.epage=449&rft.pages=441-449&rft.issn=1941-3289&rft.eissn=1941-3297&rft_id=info:doi/10.1161/CIRCHEARTFAILURE.110.959312&rft_dat=%3Cproquest_cross%3E878595889%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=878595889&rft_id=info:pmid/21576281&rfr_iscdi=true |