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  • Title: Changes in diastolic function after exercise training in patients with and without diabetes mellitus after coronary artery bypass surgery. A randomized controlled trial.
    Author: Wu YT, Wu YW, Hwang CL, Wang SS.
    Journal: Eur J Phys Rehabil Med; 2012 Sep; 48(3):351-60. PubMed ID: 22641251.
    Abstract:
    BACKGROUND: Left ventricular diastolic dysfunction and diabetes were associated with prognosis after coronary artery bypass surgery (CABG). AIM: This study investigated whether short-term exercise improves diastolic function in patients with and without diabetes mellitus (DM) after CABG and examined the relationship of these changes to exercise capacity. DESIGN: RCT SETTING: Outpatient. POPULATION: Patients with left ventricular ejection fraction ≥50% after CABG were included in this study. METHODS: Participants were randomly assigned to a control (N.=33) or exercise (N.=28) group. The exercise group participated in three-month treadmill exercise training. We evaluated all participants on diastolic function, peak oxygen uptake (VO(2peak)), and concomitant stroke volume. RESULTS: Exercise significantly enhanced VO(2peak) to a similar extent in all patients (P<0.05). Patients with DM improved in arteriovenous oxygen difference ([a-v] O(2) diff) after training (p=0.016), whereas those without DM improved in deceleration time of early filling (p=0.031) with exercise training. The magnitude of improvement in VO(2peak) correlated with the change in (a-v) O(2) diff in patients regardless of DM (r=0.442~0.542) and with baseline (a-v) O(2) diff only in patients with DM (r=-0.480). CONCLUSION: After CABG, all patients showed similar improvements in VO(2peak) with exercise training, mainly through increased (a-v) O(2) diff, but those without DM showed greater improvements in deceleration time. CLINICAL REHABILITATION IMPACT: Exercise training is beneficial for improving exercise capacity associated with restorations of peripheral oxygen utilization in both patients with and without DM.
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