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Published on: April 19, 2019
Exercise Training, Cardiac Biomarkers, and Cardiorespiratory Fitness in Type 2 Diabetes: The HART-D Study
Kershaw V Patel1, Amit Saha2, Colby R Ayers2
1Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA.
Exercise training did not alter cardiac biomarkers like high-sensitivity cardiac troponin T (hs-cTnT) or N-terminal pro-B-type natriuretic peptide (NT-proBNP) in adults with type 2 diabetes. Higher baseline hs-cTnT was linked to reduced cardiorespiratory fitness gains.
Area of Science:
- Cardiology
- Endocrinology
- Exercise Physiology
Background:
- Type 2 diabetes (T2D) is associated with increased heart failure risk.
- Cardiac biomarkers, high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP), are elevated in T2D and predict heart failure.
- Understanding factors influencing these biomarkers in T2D is crucial for cardiovascular risk management.
Purpose of the Study:
- To investigate the impact of exercise training (ET) on hs-cTnT and NT-proBNP levels in adults with T2D.
- To assess the relationship between cardiorespiratory fitness (VO2peak) and these cardiac biomarkers after ET.
- To identify potential predictors of biomarker changes and fitness improvements.
Main Methods:
- Analysis of data from the HART-D trial, including participants with T2D randomly assigned to ET or control groups.
- Measurement of hs-cTnT, NT-proBNP, and cardiorespiratory fitness (VO2peak) at baseline and after 9 months.
- Statistical analysis using ANCOVA for ET effects and multivariable regression for associations.
Main Results:
- Exercise training (n=135) did not significantly alter hs-cTnT or NT-proBNP compared to the control group (n=31).
- Neither ET nor VO2peak changes were significantly associated with follow-up biomarker levels.
- In the ET group, higher baseline hs-cTnT was inversely associated with improvements in VO2peak.
Conclusions:
- Exercise training does not appear to modify cardiac biomarkers hs-cTnT and NT-proBNP in individuals with type 2 diabetes.
- Baseline hs-cTnT levels may indicate a blunted cardiorespiratory fitness response to exercise in this population.
- Further research is needed to explore interventions that effectively improve cardiac biomarkers and cardiorespiratory fitness in T2D.
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