K J Stewart1, P Ouyang, A C Bacher, S Lima, E P Shapiro. 1. The Division of Cardiology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA. kstewart@jhmi.edu
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.
RCT Entities:
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.
Authors: M L Pollock; B A Franklin; G J Balady; B L Chaitman; J L Fleg; B Fletcher; M Limacher; I L Piña; R A Stein; M Williams; T Bazzarre Journal: Circulation Date: 2000-02-22 Impact factor: 29.690
Authors: A Katz; S S Nambi; K Mather; A D Baron; D A Follmann; G Sullivan; M J Quon Journal: J Clin Endocrinol Metab Date: 2000-07 Impact factor: 5.958
Authors: Kerry J Stewart; James R DeRegis; Katherine L Turner; Anita C Bacher; Jidong Sung; Paul S Hees; Edward P Shapiro; Matthew Tayback; Pamela Ouyang Journal: J Cardiopulm Rehabil Date: 2003 Mar-Apr Impact factor: 2.081
Authors: M Fischer; A Baessler; H W Hense; C Hengstenberg; M Muscholl; S Holmer; A Döring; U Broeckel; G Riegger; H Schunkert Journal: Eur Heart J Date: 2003-02 Impact factor: 29.983
Authors: Jidong Sung; Pamela Ouyang; Anita C Bacher; Katherine L Turner; Jamie R DeRegis; Paul S Hees; Harry A Silber; Edward P Shapiro; Kerry J Stewart Journal: Am Heart J Date: 2002-07 Impact factor: 4.749
Authors: Aram V Chobanian; George L Bakris; Henry R Black; William C Cushman; Lee A Green; Joseph L Izzo; Daniel W Jones; Barry J Materson; Suzanne Oparil; Jackson T Wright; Edward J Roccella Journal: JAMA Date: 2003-05-14 Impact factor: 56.272
Authors: K J Stewart; J R Deregis; K L Turner; A C Bacher; J Sung; P S Hees; M Tayback; P Ouyang Journal: J Intern Med Date: 2002-11 Impact factor: 8.989
Authors: Samuel S Gidding; Mercedes R Carnethon; Stephen Daniels; Kiang Liu; David R Jacobs; Steve Sidney; Julius Gardin Journal: J Am Soc Echocardiogr Date: 2010-07-01 Impact factor: 5.251
Authors: Ada Tang; Janice J Eng; Andrei V Krassioukov; Kenneth M Madden; Azam Mohammadi; Michael Y C Tsang; Teresa S M Tsang Journal: Int J Stroke Date: 2013-10-22 Impact factor: 5.266