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| Name | Class |
|---|---|
| Jessa Hospital | OTHER |
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According to data of the International Diabetes Federation (IDF), diabetes in general affects approximately 415 million people worldwide and this number is still increasing. Cardiovascular diseases, one of the major complications of diabetes, are the leading cause of mortality and morbidity in the diabetic population. One of the cardiovascular complications is diabetic cardiomyopathy, in which structural and functional changes occur in the heart impairing cardiac function.
Exercise training has already proven the benefits on glycemic control in diabetes. This is also the case for the effects on cardiac function. However, as results are conflicting, it remains unclear which elements of exercise training should be focused on. For instance, high-intensity interval training (HIIT) is gaining interest as positive effects are already shown on glycemic control. Therefore, the potential of HIIT to improve cardiac function in diabetes should be investigated. Further on, the effects of exercise training on cardiac function are mainly investigated during rest by the use of transthoracic echocardiography. Therefore, as data are lacking, it remains unclear how the diabetic heart functions during exercise.
The aim of the present study is to investigate the effects of different training modalities (e.g. HIIT) on heart function in diabetes both during rest and during exercise itself. Therefore, cardiac function will be evaluated by the use transthoracic (exercise) echocardiography. This will be combined by the evaluation of several biochemical parameters.
The results will provide more insight in the pathology of diabetic cardiomyopathy as well as the potential of exercise training for this cardiovascular complication. Eventually, this research will contribute to the optimization of exercise programs for patients with diabetes.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| training group 1: HIIT | Active Comparator | high-intensity interval exercise training group (T2DM patients) |
|
| training group 2: MIT | Active Comparator | moderate-intensity exercise training group (T2DM patients) |
|
| Detraining period | No Intervention | Follow-up: detraining of group 1 and 2 (T2DM patients) | |
| Healthy controls | No Intervention |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| high-intensity interval exercise training (HIIT) | Other | This program includes 24 weeks of exercise training and is divided in different phases (phase 1: week 1-2, equal to the MIT group, phase 2: week 3-6, 6 bouts of high-intensity exercise, phase 3: week 7-12, 7 bouts of high-intensity exercise, phase 4: week 13-24, 8 bouts of high-intensity exercise). The exercise training program consists of 3 exercise sessions per week (for 6 months). |
| Measure | Description | Time Frame |
|---|---|---|
| Transthoracic echocardiography (TTE) during excercise | heart function during exercise by means of standard echocardiography: evaluation of diastolic and systolic function (mitral inflow pattern, ejection fraction, tissue doppler imaging, strain rate analyses,…) and cardiac structure (left ventricle mass, intraventricular wall mass,…) | day 1 |
| Transthoracic echocardiography (TTE) during excercise | heart function during exercise by means of standard echocardiography: evaluation of diastolic and systolic function (mitral inflow pattern, ejection fraction, tissue doppler imaging, strain rate analyses,…) and cardiac structure (left ventricle mass, intraventricular wall mass,…) | month 3 |
| Transthoracic echocardiography (TTE) during excercise | heart function during exercise by means of standard echocardiography: evaluation of diastolic and systolic function (mitral inflow pattern, ejection fraction, tissue doppler imaging, strain rate analyses,…) and cardiac structure (left ventricle mass, intraventricular wall mass,…) | month 6 |
| Transthoracic echocardiography (TTE) during excercise | heart function during exercise by means of standard echocardiography: evaluation of diastolic and systolic function (mitral inflow pattern, ejection fraction, tissue doppler imaging, strain rate analyses,…) and cardiac structure (left ventricle mass, intraventricular wall mass,…) | month 12 |
| Transthoracic echocardiography (TTE) | heart function in rest by means of standard echocardiography: evaluation of diastolic and systolic function (mitral inflow pattern, ejection fraction, tissue doppler imaging, strain rate analyses,…) and cardiac structure (left ventricle mass, intraventricular wall mass,…) |
| Measure | Description | Time Frame |
|---|---|---|
| Glycemic control | glycemic concentrations, HbA1c levels, insulin sensitivity, inflammation, cardiac biomarkers | day 1 |
| Glycemic control | glycemic control, insulin sensitivity, inflammation, cardiac biomarkers |
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Inclusion Criteria:
type 2 diabetes patients:
Healthy controls:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Jessa Ziekenhuis | Hasselt | 3500 | Belgium |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35038022 | Derived | Van Ryckeghem L, Keytsman C, De Brandt J, Verboven K, Verbaanderd E, Marinus N, Franssen WMA, Frederix I, Bakelants E, Petit T, Jogani S, Stroobants S, Dendale P, Bito V, Verwerft J, Hansen D. Impact of continuous vs. interval training on oxygen extraction and cardiac function during exercise in type 2 diabetes mellitus. Eur J Appl Physiol. 2022 Apr;122(4):875-887. doi: 10.1007/s00421-022-04884-9. Epub 2022 Jan 17. | |
| 33623980 |
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|
| moderate-intensity exercise training (MIT) | Other | This program includes 24 weeks of exercise training and is not devided in phases. The exercise training program consists of 3 endurance exercise sessions per week (for 6 months). The total exercise volume equals the exercise volume of the HIIT group. |
|
| day 1 |
| Transthoracic echocardiography (TTE) | heart function in rest by means of standard echocardiography: evaluation of diastolic and systolic function (mitral inflow pattern, ejection fraction, tissue doppler imaging, strain rate analyses,…) and cardiac structure (left ventricle mass, intraventricular wall mass,…) | month 3 |
| Transthoracic echocardiography (TTE) | heart function in rest by means of standard echocardiography: evaluation of diastolic and systolic function (mitral inflow pattern, ejection fraction, tissue doppler imaging, strain rate analyses,…) and cardiac structure (left ventricle mass, intraventricular wall mass,…) | month 6 |
| Transthoracic echocardiography (TTE) | heart function in rest by means of standard echocardiography: evaluation of diastolic and systolic function (mitral inflow pattern, ejection fraction, tissue doppler imaging, strain rate analyses,…) and cardiac structure (left ventricle mass, intraventricular wall mass,…) | month 12 |
| ECG (Electrocardiogram) during excercise | ECG during excercise (an incremental exercise test on a cycle) | month 3 |
| ECG (Electrocardiogram) during excercise | ECG during excercise (an incremental exercise test on a cycle) | month 12 |
| ECG (Electrocardiogram) | ECG in rest | month 3 |
| ECG (Electrocardiogram) | ECG in rest | month 12 |
| month 3 |
| Glycemic control | glycemic concentrations, HbA1c levels, insulin sensitivity, inflammation, cardiac biomarkers | month 6 |
| Glycemic control | glycemic concentrations, HbA1c levels, insulin sensitivity, inflammation, cardiac biomarkers | month 12 |
| Insulin metabolism | Fasting serum insulin, homeostasis model assessment insulin resistance and measures of central insulin sensitivity derived from an oral glucose tolerance test (75g) | day 1 |
| Insulin metabolism | Fasting serum insulin, homeostasis model assessment insulin resistance and measures of central insulin sensitivity derived from an oral glucose tolerance test (75g) | month 3 |
| Insulin metabolism | Fasting serum insulin, homeostasis model assessment insulin resistance and measures of central insulin sensitivity derived from an oral glucose tolerance test (75g) | month 6 |
| Insulin metabolism | Fasting serum insulin, homeostasis model assessment insulin resistance and measures of central insulin sensitivity derived from an oral glucose tolerance test (75g) | month 12 |
| Cardiac function | Cardiac biomarkers (brain-derived natriuretic peptide (BNP) levels, cardiac troponin levels) | day 1 |
| Cardiac function | Cardiac biomarkers (BNP levels, cardiac troponin levels) | month 3 |
| Cardiac function | Cardiac biomarkers (BNP levels, cardiac troponin levels) | month 6 |
| Cardiac function | Cardiac biomarkers (BNP levels, cardiac troponin levels) | month 12 |
| Inflammation and oxidative stress | C reactive protein (CRP) levels, tumor necrosis factor-(TNF)alpha levels, interleukin (IL)-10 (interleukin) levels, oxidative stress markers (superoxide dismutase (SOD), malondialdehyde (MDA), glutathione peroxidase (GPX)) | day 1 |
| Inflammation and oxidative stress | CRP levels, TNF-alpha levels, IL-10 levels, oxidative stress markers (SOD, MDA, GPX) | month 3 |
| Inflammation and oxidative stress | CRP levels, TNF-alpha levels, IL-10 levels, oxidative stress markers (SOD, MDA , GPX) | month 6 |
| Inflammation and oxidative stress | CRP levels, TNF-alpha levels, IL-10 levels, oxidative stress markers (SOD, MDA, GPX) | month 12 |
| body composition | body composition, measured using dual x-ray absorptiometry | day 1 |
| body composition | body composition, measured using dual x-ray absorptiometry | month 6 |
| Maximal oxygen uptake (ml/O2/kg/min) | exercise capacity measured using indirect calorimetry and an incremental bicycle exercise protocol | day 1 |
| Maximal oxygen uptake (ml/O2/kg/min) | exercise capacity measured using indirect calorimetry and an incremental bicycle exercise protocol | month 3 |
| Maximal oxygen uptake (ml/O2/kg/min) | exercise capacity measured using indirect calorimetry and an incremental bicycle exercise protocol | month 6 |
| Maximal oxygen uptake (ml/O2/kg/min) | exercise capacity measured using indirect calorimetry and an incremental bicycle exercise protocol | month 12 |
| Derived |
| Van Ryckeghem L, Keytsman C, Verboven K, Verbaanderd E, Frederix I, Bakelants E, Petit T, Jogani S, Stroobants S, Dendale P, Bito V, Verwerft J, Hansen D. Exercise capacity is related to attenuated responses in oxygen extraction and left ventricular longitudinal strain in asymptomatic type 2 diabetes patients. Eur J Prev Cardiol. 2022 Jan 11;28(16):1756-1766. doi: 10.1093/eurjpc/zwaa007. |
| 33417036 | Derived | Van Ryckeghem L, Keytsman C, Verbaanderd E, Frederix I, Bakelants E, Petit T, Jogani S, Stroobants S, Dendale P, Bito V, Verwerft J, Hansen D. Asymptomatic type 2 diabetes mellitus display a reduced myocardial deformation but adequate response during exercise. Eur J Appl Physiol. 2021 Mar;121(3):929-940. doi: 10.1007/s00421-020-04557-5. Epub 2021 Jan 8. |
| ID | Term |
|---|---|
| D058065 | Diabetic Cardiomyopathies |
| D003924 | Diabetes Mellitus, Type 2 |
| ID | Term |
|---|---|
| D009202 | Cardiomyopathies |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D048909 | Diabetes Complications |
| D003920 | Diabetes Mellitus |
| D004700 | Endocrine System Diseases |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
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