Exercise and weight loss improve exercise capacity independent of cardiac function in metabolic syndrome.

Hypertension, diabetes and obesity cause cardiac diastolic dysfunction (DD) which could reduce exercise capacity. Our aim was to determine if 10% weight loss by exercise at 60% VO(2max) five days/week (approximately -375 kcal/session) and caloric restriction (approximately -600 kcal/d) over 6 months improves exercise capacity and DD in Metabolic syndrome (MetS). Eighteen subjects (40 +/- 1y, women = 6, BMI = 33.5 +/- 1.0 kg/m(2)) successfully completed the study. Maximal treadmill stress echocardiography was performed at baseline and post weight loss to determine VO(2max), resting and stress DD as the ratio of peak early diastolic mitral inflow velocity (E) to tissue Doppler early diastolic annular decent (E'). After weight loss (mean = 9.5 +/- 0.2%), all metabolic parameters improved. Resting and stress E/E' values remained normal before and after weight loss. Exercise intolerance is likely due to general deconditioning and not cardiac dysfunction in early MetS as VO(2max) increases significantly with lifestyle while cardiac function remains unchanged.