Effect of Exercise Intervention on Cardiac Function in Type 2 Diabetes Mellitus: A Systematic Review
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SYSTEMATIC REVIEW
Effect of Exercise Intervention on Cardiac Function in Type 2 Diabetes Mellitus: A Systematic Review Maxim Verboven1 · Lisa Van Ryckeghem1,2 · Jamal Belkhouribchia1,2 · Paul Dendale1,3 · Bert O. Eijnde1 · Dominique Hansen1,2,3 · Virginie Bito1 Published online: 24 October 2018 © Springer Nature Switzerland AG 2018
Abstract Background The effect of exercise on cardiac function/structure in type 2 diabetes mellitus (T2DM) with or without diabetic cardiomyopathy (DCM) is not yet completely understood. To date, results of studies have been controversial with variable outcomes due to the variety of exercise modalities. Objectives The aim of the present review was to examine the impact of exercise intervention, and different types of exercise, on cardiac function and structure in T2DM through a systematic literature review, combining both pre-clinical and clinical studies. Methods A systematic literature search was performed on PubMed, Web of Science, and PEDro to identify studies up to 2 April 2018. Articles were included when well-defined exercise protocols were provided, and cardiac function in T2DM patients or validated animal models was examined. Results In diabetic animals, improvements in both diastolic and systolic function through exercise therapy were mainly attributed to reduced collagen deposition. In T2DM patients, improvements were observed in diastolic function, but not consistently in systolic function, after endurance (and combined resistance) exercise training. Different exercise intervention modalities and exercise types seemed equally effective in improving cardiac structure and function. Conclusion Exercise training elicits significant improvements in diastolic function and beneficial remodeling in T2DM and DCM animal models, but not necessarily improvements in systolic function and left ventricular structure, regardless of exercise type. Therefore, exercise intervention should be a cornerstone in the treatment of T2DM patients not only to improve glycemic control but also to specifically enhance cardiac function.
Key Points
Maxim Verboven, Lisa Van Ryckeghem, Dominique Hansen, and Virginie Bito have shared authorship. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s40279-018-1003-4) contains supplementary material, which is available to authorized users. * Dominique Hansen [email protected] 1
BIOMED‑Biomedical Research Centre, Faculty of Medicine and Life Sciences, Hasselt University, Agoralaan building C, 3590 Diepenbeek, Belgium
2
REVAL‑Rehabilitation Research Centre, Faculty of Rehabilitation Sciences, Hasselt University, Agoralaan building A, 3590 Diepenbeek, Belgium
3
Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium
In this systematic literature review, exercise intervention is shown to improve diastolic function and counteract adverse remodeling leading to cardiac dysfunction in animals and humans with type 2 diabetes mellitus (T2DM) or diabetic cardiomyopathy. Given the therapeutic effe
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