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Effect of Exercise Intervention on Cardiac Function in Type 2 Diabetes Mellitus: A Systematic Review

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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.

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Author notes

  1. Maxim Verboven, Lisa Van Ryckeghem, Dominique Hansen, and Virginie Bito have shared authorship.

Authors and Affiliations

  1. BIOMED-Biomedical Research Centre, Faculty of Medicine and Life Sciences, Hasselt University, Agoralaan building C, 3590, Diepenbeek, Belgium

    Maxim Verboven, Lisa Van Ryckeghem, Jamal Belkhouribchia, Paul Dendale, Bert O. Eijnde, Dominique Hansen & Virginie Bito

  2. REVAL-Rehabilitation Research Centre, Faculty of Rehabilitation Sciences, Hasselt University, Agoralaan building A, 3590, Diepenbeek, Belgium

    Lisa Van Ryckeghem, Jamal Belkhouribchia & Dominique Hansen

  3. Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium

    Paul Dendale & Dominique Hansen

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  1. Maxim Verboven
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Correspondence to Dominique Hansen.

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Funding

No sources of funding were used to assist in the preparation of this article. Funding was provided by BOF-scholarship from Hasselt University (Grant no. 15NI06-BOF).

Conflict of interest

Maxim Verboven, Lisa Van Ryckeghem, Jamal Belkhouribchia, Paul Dendale, Bert O. Eijnde, Dominique Hansen, and Virginie Bito declare that they have no conflicts of interest relevant to the content of this review.

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Verboven, M., Van Ryckeghem, L., Belkhouribchia, J. et al. Effect of Exercise Intervention on Cardiac Function in Type 2 Diabetes Mellitus: A Systematic Review. Sports Med 49, 255–268 (2019). https://doi.org/10.1007/s40279-018-1003-4

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