title: Improved arterial-ventricular coupling in metabolic syndrome after exercise training: a pilot study.
abstract: OBJECTIVE
  The metabolic syndrome (MetS) is associated with threefold increased risk of cardiovascular (CV) morbidity and mortality, which is partly due to a blunted CV reserve capacity, reflected by a reduced peak exercise left ventricular (LV) contractility and aerobic capacity and a blunted peak arterial-ventricular coupling. To date, no study has examined whether aerobic exercise training in MetS can reverse peak exercise CV dysfunction. Furthermore, examining how exercise training alters CV function in a group of individuals with MetS before the development of diabetes and/or overt CV disease can provide insights into whether some of the pathophysiological CV changes can be delayed/reversed, lowering their CV risk. The objective of this study was to examine the effects of 8 wk of aerobic exercise training in individuals with MetS on resting and peak exercise CV function.
  
  
  METHODS
  Twenty participants with MetS underwent either 8 wk of aerobic exercise training (MetS-ExT, n = 10) or remained sedentary (MetS-NonT, n = 10) during this period. Resting and peak exercise CV function was characterized using Doppler echocardiography and gas exchange.
  
  
  RESULTS
  Exercise training did not alter resting LV diastolic or systolic function and arterial-ventricular coupling in MetS. In contrast, at peak exercise, an increase in LV contractility (40%, P < 0.01), cardiac output (28%, P < 0.05), and aerobic capacity (20%, P < 0.01), but a reduction in vascular resistance (30%, P < 0.05) and arterial-ventricular coupling (27%, P < 0.01), were noted in the MetS-ExT but not in the MetS-NonT group. Furthermore, an improvement in lifetime risk score was also noted in the MetS-ExT group.
  
  
  CONCLUSIONS
  These findings have clinical importance because they provide insight that some of the pathophysiological changes associated with MetS can be improved and can lower the risk of CV disease.
authors.affiliation: 1Department of Human Performance and Applied Sciences, Division of Exercise Physiology, School of Medicine, West Virginia University, Morgantown, WV; and 2Center for Cardiovascular and Respiratory Sciences, School of Medicine, West Virginia University, Morgantown, WV.
authors.forename: Sara B
authors.initials: SB
authors.lastname: Fournier
authors.forename: David A
authors.initials: DA
authors.lastname: Donley
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Bonner
authors.forename: Evan
authors.initials: E
authors.lastname: Devallance
authors.forename: I Mark
authors.initials: IM
authors.lastname: Olfert
authors.forename: Paul D
authors.initials: PD
authors.lastname: Chantler
mesh_terms: D000328:Adult; D015308:Anaerobic Threshold; D015150:Echocardiography, Doppler; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000503:physiopathology* / Q000628:therapy*; D008875:Middle Aged; D009200:Myocardial Contraction; D010101:Oxygen Consumption; D010865:Pilot Projects; D011659:Pulmonary Gas Exchange; D012146:Rest / Q000502:physiology; D013318:Stroke Volume; D014655:Vascular Resistance; D016277:Ventricular Function, Left / Q000502:physiology*