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European Journal of Physical and Rehabilitation Medicine 2012 September;48(3):351-60

Copyright © 2012 EDIZIONI MINERVA MEDICA

lingua: Inglese

Changes in diastolic function after exercise training in patients with and without diabetes mellitus after coronary artery bypass surgery. A randomized controlled trial

Wu Y. T. 1, Wu Y. W. 2, Hwang C. L. 1, Wang S. S. 3

1 School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei City, Taiwan; 2 Department of Nuclear Medicine, National Taiwan University Hospital; College of Medicine, National Taiwan University, Taipei City, Taiwan; 3 Department of Surgery, National Taiwan University Hospital; College of Medicine, National Taiwan University, Taipei City, Taiwan


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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 (VO2peak), and concomitant stroke volume.
RESULTS: Exercise significantly enhanced VO2peak to a similar extent in all patients (P<0.05). Patients with DM improved in arteriovenous oxygen difference ([a-v] O2 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 VO2peak correlated with the change in (a-v) O2 diff in patients regardless of DM (r=0.442~0.542) and with baseline (a-v) O2 diff only in patients with DM (r=-0.480).
CONCLUSION: After CABG, all patients showed similar improvements in VO2peak with exercise training, mainly through increased (a-v) O2 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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