The impact of lifestyle intervention on left atrial function in type 2 diabetes: results from the DIASTOLIC study

The International Journal of Cardiovascular Imaging - Tập 38 Số 9 - Trang 2013-2023
Aseel Alfuhied1,2,3, Gaurav S Gulsin1,3, Lavanya Athithan1,3, Emer M Brady1,3, Kelly Parke1,3, Joseph Henson1,4,3, Emma Redman1,4,3, Anna-Marie Marsh1,3, Thomas Yates1,4,3, Melanie J. Davies4, Gerry P McCann1,3, Anvesha Singh1,3
1Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
2King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia
3National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
4Diabetes Research Centre, NIHR Leicester Biomedical Research Centre, Leicester, UK

Tóm tắt

AbstractAerobic exercise training and low energy diets have been shown to improve left ventricular remodelling and diastolic function in adults with type 2 diabetes (T2D), albeit with differential effects. The impact of these lifestyle interventions on left atrial (LA) function, however, has not previously been reported. The DIASTOLIC study was a prospective, randomised, open-label, blind endpoint trial, in which 90 people with obesity and T2D and no prevalent cardiovascular disease were randomised to a 12-week intervention of: (i) routine care, (ii) aerobic exercise training, or (iii) low energy (≈ 810 kcal/day) meal replacement plan (MRP). Cardiac magnetic resonance (CMR) imaging was performed pre- and post-intervention. Image analysis included LA volumes (LAV), emptying fraction (LAEF), and LA strain (LAS) corresponding to LA reservoir (LAS-r), conduit (LAS-cd), and booster pump (LAS-bp) function. 73 participants with T2D (mean age 50 ± 6 years, 62% male, body mass index (BMI) 36.1 ± 5.3 kg/m2) completed the trial and had analysable LA images. There was no significant change in CMR measured LA volumetric function (LAV/LAEF) in any group. The routine care group showed no significant change in BMI or LAS. In the MRP group, there were significant reductions in BMI (4.5 kg/m2) and a significant increase in LAS-r and LAS-bp (29.9 ± 7.0 to 32.3 ± 7.0%, p = 0.036 and 14.6 ± 5.3 to 17.2 ± 3.7%, p = 0.034). The exercise group showed a small reduction in BMI (0.49 kg/m2), with no significant change in LAS. Compared to routine care, weight loss via a 12-week MRP, led to improvements in LA filling and contractile function in adults with T2D and obesity. However, these within-group changes were not statistically significant on between-group comparison. ClinicalTrials.gov Identifier: NCT02590822.

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The International Journal of Cardiovascular Imaging

Tập 38 Số 9

2013-2023

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