High-Intensity Interval Exercise Effectively Improves Cardiac Function in Patients With Type 2 Diabetes Mellitus and Diastolic Dysfunction

Hollekim-Strand, Siri Marte; Bjørgaas, Marit Rokne; Albrektsen, Grethe; Tjønna, Arnt Erik; Wisløff, Ulrik; Ingul, Charlotte Björk

doi:10.1016/j.jacc.2014.07.971

Cited by 119 publications

(137 citation statements)

References 2 publications

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“…236,237,285 For example, Gormley et al studied 61 healthy young men and women who were randomized to a nonexercise control group or 1 of 3 exercise groups: MICT (60 minutes, 4 days per week at 50% V was significantly different between each of the exercise groups, demonstrating a dose response for exercise intensity at the high end of the intensity spectrum. HIT and MICT effects on CRF have also been compared in healthy obese men and women, 258 people with metabolic syndrome, 261 hypertensive patients, 250 and patients with T2DM, 238 with HIT eliciting significantly greater increases in CRF than MICT despite similar energy expenditure.…”

Section: High-intensity Training and Crfmentioning

confidence: 99%

Importance of Assessing Cardiorespiratory Fitness in Clinical Practice: A Case for Fitness as a Clinical Vital Sign: A Scientific Statement From the American Heart Association

Ross¹,

Blair²,

Arena³

et al. 2016

Circulation

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1,756

1,697

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ABSTRACT:Mounting evidence has firmly established that low levels of cardiorespiratory fitness (CRF) are associated with a high risk of cardiovascular disease, all-cause mortality, and mortality rates attributable to various cancers. A growing body of epidemiological and clinical evidence demonstrates not only that CRF is a potentially stronger predictor of mortality than established risk factors such as smoking, hypertension, high cholesterol, and type 2 diabetes mellitus, but that the addition of CRF to traditional risk factors significantly improves the reclassification of risk for adverse outcomes. The purpose of this statement is to review current knowledge related to the association between CRF and health outcomes, increase awareness of the added value of CRF to improve risk prediction, and suggest future directions in research. Although the statement is not intended to be a comprehensive review, critical references that address important advances in the field are highlighted. The underlying premise of this statement is that the addition of CRF for risk classification presents health professionals with unique opportunities to improve patient management and to encourage lifestyle-based strategies designed to reduce cardiovascular risk. These opportunities must be realized to optimize the prevention and treatment of cardiovascular disease and hence meet the American Heart Association's 2020 goals.M ounting evidence over the past 3 decades has firmly established that low levels of cardiorespiratory fitness (CRF) are associated with a high risk of cardiovascular disease (CVD) and all-cause mortality, as well as mortality rates attributable to various cancers, especially of the breast and colon/digestive tract. [1][2][3][4] Importantly, improvements in CRF are associated with reduced mortality risk.5 Although CRF is now recognized as an important marker of cardiovascular health, it is currently the only major risk factor not routinely assessed in clinical practice.In 2013, the American Heart Association and the American College of Cardiology jointly released new guidelines for the prevention and treatment of coronary artery disease.6 Although CRF is the fourth-leading risk factor for CVD and has long been established as a significant prognostic marker, 7 it was excluded from the risk calculator. The authors of the guidelines noted that the evidence that CRF would enhance risk classification was inconclusive, and thus, the added contribution of CRF to determine CVD risk was uncertain. There is, however, a large body of epidemiological and clinical evidence demonstrating not only that CRF is a potentially stronger predictor of mortality than established risk factors such as smoking, hypertension, high cholesterol, and type 2 diabetes mellitus (T2DM), but that the addition of CRF to traditional risk factors significantly improves the reclassification of risk for adverse outcomes.

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Section: High-intensity Training and Crfmentioning

confidence: 99%

Importance of Assessing Cardiorespiratory Fitness in Clinical Practice: A Case for Fitness as a Clinical Vital Sign: A Scientific Statement From the American Heart Association

Ross¹,

Blair²,

Arena³

et al. 2016

Circulation

Self Cite

1,756

1,697

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show abstract

“…They involved assessments of HIIT versus MCT for patients with CAD, including metabolic syndrome (n=10) (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27), and CHF, including diastolic dysfunction (n=11) (15,16,(28)(29)(30)(31)(32)(33)(34)(35)(36). In the studies shown in Tables 1 and 2, although the VO2peak was not necessarily the primary endpoint, we presented the VO2peak at baseline and the percentage increase in the VO2peak during the exercise period in order to compare the two groups.…”

Section: Benefits Of Hiitmentioning

confidence: 99%

“…Variables other than the VO2peak, in which HIIT is superior to MCT, are summarized in Table 3 (15,16,21,24,26,28,31,32,34).…”

Section: Rcts Comparing Central and Peripheral Adaptations In Hiit Anmentioning

confidence: 99%

“…One of these studies (11) involving more than 260 patients, the superiority of HIIT in patients with CAD was demonstrated. The latest evidence for HIIT was shown in two recently published studies (15,16) describing its effects even on left ventricular (LV) diastolic dysfunction that had not been treated with effective drugs. In this review, we aim to examine the latest advances in HIIT in terms of the maximal/peak VO2 (VO2max/peak) improvement and central and peripheral adaptations.…”

Section: Introductionmentioning

confidence: 99%

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Review of High-intensity Interval Training in Cardiac Rehabilitation

2016

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For the secondary prevention of cardiovascular disease, comprehensive cardiac rehabilitation is required. This involves optimal medical therapy, education on nutrition and exercise therapy, and smoking cessation. Of these, efficient exercise therapy is a key factor. A highly effective training protocol is therefore warranted, which requires a high rate of compliance. Although moderate-intensity continuous training has been the main training regimen recommended in cardiac rehabilitation guidelines, high-intensity interval training has been reported to be more effective in the clinical and experimental setting from the standpoint of peak oxygen uptake and central and peripheral adaptations. In this review, we illustrate the scientific evidence for highintensity interval training. We then verify this evidence and discuss its significance and the remaining issues.

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“…A 10% increase in peak O 2 pulse, which is an estimate of peak left ventricular stroke volume (Whipp et al 1996), has been observed after three months of aerobic training in type 1 diabetes adults (Rigla et al 2000). In addition, echocardiography studies in patients with type 2 diabetes have produced contradictory findings: Both training-induced improvements (Hollekim-Strand et al 2014) and no improvements (Ofstad et al 2014) in myocardial function have been observed with high training intensity possibly leading to more pronounced effects (Hollekim-Strand et al 2014). In the current study, peak O 2 pulse rose in a similar manner in the training groups (T1D: 10%, CON: 11%) after the long-term one-year exposure to regular exercise, suggesting a similar improvement in cardiac pump function in the groups.…”

Section: Discussionmentioning

confidence: 99%

One-year unsupervised individualized exercise training intervention enhances cardiorespiratory fitness but not muscle deoxygenation or glycemic control in adults with type 1 diabetes

Rissanen

Tikkanen

Koponen

et al. 2018

Appl. Physiol. Nutr. Metab.

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Adaptations to long-term exercise training in type 1 diabetes are sparsely studied. We examined the effects of a 1-year individualized training intervention on cardiorespiratory fitness, exercise-induced active muscle deoxygenation, and glycemic control in adults with and without type 1 diabetes. Eight men with type 1 diabetes (T1D) and 8 healthy men (CON) matched for age, anthropometry, and peak pulmonary O2 uptake, completed a 1-year individualized training intervention in an unsupervised real-world setting. Before and after the intervention, the subjects performed a maximal incremental cycling test, during which alveolar gas exchange (volume turbine and mass spectrometry) and relative concentration changes in active leg muscle deoxygenated (Δ[HHb]) and total (Δ[tHb]) hemoglobin (near-infrared spectroscopy) were monitored. Peak O2 pulse, reflecting peak stroke volume, was calculated (peak pulmonary O2 uptake/peak heart rate). Glycemic control (glycosylated hemoglobin A1c (HbA1c)) was evaluated. Both T1D and CON averagely performed 1 resistance-training and 3–4 endurance-training sessions per week (∼1 h/session at ∼moderate intensity). Training increased peak pulmonary O2 uptake in T1D (p = 0.004) and CON (p = 0.045) (group × time p = 0.677). Peak O2 pulse also rose in T1D (p = 0.032) and CON (p = 0.018) (group × time p = 0.880). Training increased leg Δ[HHb] at peak exercise in CON (p = 0.039) but not in T1D (group × time p = 0.052), while no changes in leg Δ[tHb] at any work rate were observed in either group (p > 0.05). HbA1c retained unchanged in T1D (from 58 ± 10 to 59 ± 11 mmol/mol, p = 0.609). In conclusion, 1-year adherence to exercise training enhanced cardiorespiratory fitness similarly in T1D and CON but had no effect on active muscle deoxygenation or glycemic control in T1D.

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High-Intensity Interval Exercise Effectively Improves Cardiac Function in Patients With Type 2 Diabetes Mellitus and Diastolic Dysfunction

Cited by 119 publications

References 2 publications

Importance of Assessing Cardiorespiratory Fitness in Clinical Practice: A Case for Fitness as a Clinical Vital Sign: A Scientific Statement From the American Heart Association

Importance of Assessing Cardiorespiratory Fitness in Clinical Practice: A Case for Fitness as a Clinical Vital Sign: A Scientific Statement From the American Heart Association

Review of High-intensity Interval Training in Cardiac Rehabilitation

One-year unsupervised individualized exercise training intervention enhances cardiorespiratory fitness but not muscle deoxygenation or glycemic control in adults with type 1 diabetes

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