Exercise Effects on Cardiac Size and Left Ventricular Diastolic Function: Relationships to Changes in Fitness, Fatness, Blood Pressure and Insulin Resistance

Overview

Journal Heart

Date 2005 Nov 26

PMID 16308413

Citations 13

Authors

K J Stewart

P Ouyang

A C Bacher

S Lima

E P Shapiro

Affiliations

Soon will be listed here.

Abstract

Objectives: To determine exercise training effects on cardiac size and left ventricular (LV) diastolic function and relationships of exercise induced changes in physiological and body composition parameters with cardiac parameters.

Design: Prospective, randomised controlled trial.

Subjects: Men and women (63.6 (5.7) years, body mass index 29.5 (4.4) kg/m(2)) with untreated hypertension (systolic blood pressure (BP) 130-159 or diastolic BP 85-99 mm Hg).

Main Outcome Measures: Cardiac size and LV diastolic function, peak oxygen uptake (Vo(2)), muscle strength, general and abdominal fatness, and insulin resistance.

Interventions: 6 months of exercise training versus usual care.

Results: When analysed by group at six months, cardiac size and LV diastolic function did not differ between exercisers (n = 51) and controls (n = 53), whereas exercisers had significantly higher peak Vo(2) (28 v 24 ml/kg/min) and strength (383 v 329 kg), and lower fatness (34% v 37%), diastolic BP (73 v 75 mm Hg) and insulin resistance (quantitative insulin sensitivity check index 0.35 v 0.34) versus controls (all p <or= 0.05). By regression analysis, among six month changes, increased peak Vo(2) and reduced abdominal fat were associated with increased cardiac size. Increased peak Vo(2) and reduced abdominal fat, BP and insulin resistance were associated with improved LV diastolic function. r Values ranged from 0.20 to 0.32 (p <or= 0.05).

Conclusions: When examined by group assignment, exercise had no effect on cardiac size or LV diastolic function. When individual variations in six month changes were examined, participants attaining the greatest increases in fitness and reductions in abdominal fatness, insulin resistance and BP showed a modest trend towards physiological hypertrophy characterised by increased cardiac size and improved LV diastolic function. These results suggest that decreased abdominal fatness may have a role in improving cardiovascular health.

Citing Articles

Comparative analysis of health-related fitness in patients with acute versus chronic Chagas disease.

Clara Narcisa Silva Almeida , Ariane Cardoso Vasconcelos , Caroline da Silva Sousa , Melo Silva N, Souza D, de Carvalho C Biomedica. 2024; 44(1):67-79.

PMID: 38648351 PMC: 11349066. DOI: 10.7705/biomedica.6892.

More moderate-intensity physical activity and less prolonged sedentary time are associated with better very short-term systolic blood pressure variability in healthy adults.

Schwartz B, Shivgulam M, Petterson J, Wu Y, Frayne R, Kimmerly D J Hum Hypertens. 2023; 37(11):1015-1020.

PMID: 37185597 DOI: 10.1038/s41371-023-00832-y.

The effects of exercise training on hypertensive older adults: an umbrella meta-analysis.

Sardeli A, Griffth G, Dos Santos M, Ito M, Chacon-Mikahil M Hypertens Res. 2021; 44(11):1434-1443.

PMID: 34385687 DOI: 10.1038/s41440-021-00715-0.

Targets identified from exercised heart: killing multiple birds with one stone.

Wang H, Xie Y, Guan L, Elkin K, Xiao J NPJ Regen Med. 2021; 6(1):23.

PMID: 33837221 PMC: 8035363. DOI: 10.1038/s41536-021-00128-0.

Effects of Exercise on the Resting Heart Rate: A Systematic Review and Meta-Analysis of Interventional Studies.

Reimers A, Knapp G, Reimers C J Clin Med. 2018; 7(12).

PMID: 30513777 PMC: 6306777. DOI: 10.3390/jcm7120503.

References

Pollock M, Franklin B, Balady G, Chaitman B, Fleg J, Fletcher B . AHA Science Advisory. Resistance exercise in individuals with and without cardiovascular disease: benefits, rationale, safety, and prescription: An advisory from the Committee on Exercise, Rehabilitation, and Prevention, Council on Clinical.... Circulation. 2000; 101(7):828-33. DOI: 10.1161/01.cir.101.7.828. View

Fischer M, Baessler A, Hense H, Hengstenberg C, Muscholl M, Holmer S . Prevalence of left ventricular diastolic dysfunction in the community. Results from a Doppler echocardiographic-based survey of a population sample. Eur Heart J. 2003; 24(4):320-8. DOI: 10.1016/s0195-668x(02)00428-1. View

Haykowsky M, Humen D, Teo K, Quinney A, Souster M, Bell G . Effects of 16 weeks of resistance training on left ventricular morphology and systolic function in healthy men >60 years of age. Am J Cardiol. 2000; 85(8):1002-6. DOI: 10.1016/s0002-9149(99)00918-2. View

Katz A, Nambi S, Mather K, Baron A, Follmann D, Sullivan G . Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans. J Clin Endocrinol Metab. 2000; 85(7):2402-10. DOI: 10.1210/jcem.85.7.6661. View

Sung J, Ouyang P, Bacher A, Turner K, DeRegis J, Hees P . Peripheral endothelium-dependent flow-mediated vasodilatation is associated with left ventricular mass in older persons with hypertension. Am Heart J. 2002; 144(1):39-44. DOI: 10.1067/mhj.2002.122872. View

Stewart K . Exercise training and the cardiovascular consequences of type 2 diabetes and hypertension: plausible mechanisms for improving cardiovascular health. JAMA. 2002; 288(13):1622-31. DOI: 10.1001/jama.288.13.1622. View

Stewart K, DeRegis J, Turner K, Bacher A, Sung J, Hees P . Fitness, fatness and activity as predictors of bone mineral density in older persons. J Intern Med. 2003; 252(5):381-8. DOI: 10.1046/j.1365-2796.2002.01050.x. View

Stewart K, DeRegis J, Turner K, Bacher A, Sung J, Hees P . Usefulness of anthropometrics and dual-energy x-ray absorptiometry for estimating abdominal obesity measured by magnetic resonance imaging in older men and women. J Cardiopulm Rehabil. 2003; 23(2):109-14. DOI: 10.1097/00008483-200303000-00008. View

Park S, Park J, Kwon Y, Yoon M, Kim C . The effect of long-term aerobic exercise on maximal oxygen consumption, left ventricular function and serum lipids in elderly women. J Physiol Anthropol Appl Human Sci. 2003; 22(1):11-7. DOI: 10.2114/jpa.22.11. View

10.

Chobanian A, Bakris G, Black H, Cushman W, Green L, Izzo Jr J . The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003; 289(19):2560-72. DOI: 10.1001/jama.289.19.2560. View

11.

Pascual M, Pascual D, Soria F, Vicente T, Hernandez A, Tebar F . Effects of isolated obesity on systolic and diastolic left ventricular function. Heart. 2003; 89(10):1152-6. PMC: 1767886. DOI: 10.1136/heart.89.10.1152. View

12.

Pescatello L, Franklin B, Fagard R, Farquhar W, Kelley G, Ray C . American College of Sports Medicine position stand. Exercise and hypertension. Med Sci Sports Exerc. 2004; 36(3):533-53. DOI: 10.1249/01.mss.0000115224.88514.3a. View

13.

Peterson L, Waggoner A, Schechtman K, Meyer T, Gropler R, Barzilai B . Alterations in left ventricular structure and function in young healthy obese women: assessment by echocardiography and tissue Doppler imaging. J Am Coll Cardiol. 2004; 43(8):1399-404. DOI: 10.1016/j.jacc.2003.10.062. View

14.

Stewart K . Exercise training: can it improve cardiovascular health in patients with type 2 diabetes?. Br J Sports Med. 2004; 38(3):250-2. PMC: 1724815. DOI: 10.1136/bjsm.2004.012187. View

15.

Di Bello V, Giorgi D, Pedrinelli R, Talini E, Palagi C, Delle Donne M . Left ventricular hypertrophy and its regression in essential arterial hypertension. A tissue Doppler imaging study. Am J Hypertens. 2004; 17(10):882-90. DOI: 10.1016/j.amjhyper.2004.05.026. View

16.

Mosteller R . Simplified calculation of body-surface area. N Engl J Med. 1987; 317(17):1098. DOI: 10.1056/NEJM198710223171717. View

17.

Mureddu G, De Simone G, Greco R, Rosato G, Contaldo F . Left ventricular filling pattern in uncomplicated obesity. Am J Cardiol. 1996; 77(7):509-14. DOI: 10.1016/s0002-9149(97)89346-0. View

18.

Sasson Z, Rasooly Y, Gupta R, Rasooly I . Left atrial enlargement in healthy obese: prevalence and relation to left ventricular mass and diastolic function. Can J Cardiol. 1996; 12(3):257-63. View

19.

Jain A, Avendano G, Dharamsey S, Dasmahapatra A, Agarwal R, Reddi A . Left ventricular diastolic function in hypertension and role of plasma glucose and insulin. Comparison with diabetic heart. Circulation. 1996; 93(7):1396-402. DOI: 10.1161/01.cir.93.7.1396. View

20.

Mockel M, Stork T . Diastolic function in various forms of left ventricular hypertrophy: contribution of active Doppler stress echo. Int J Sports Med. 1996; 17 Suppl 3:S184-90. DOI: 10.1055/s-2007-972922. View