title: Exercise training improves insulin release during glucose tolerance testing in stable chronic heart failure patients.
abstract: OBJECTIVE
  Chronic heart failure (CHF) patients often present with (pre)diabetes, which negatively influences prognosis. Unlike the proven effect of exercise on glucose regulation in the general population, its effect in CHF is unclear. Therefore, this study aimed at investigating the effect of exercise training on glucose regulation in stable CHF patients.
  
  
  METHODS
  Twenty-two CHF patients were randomized into training (EX, n = 15) and control (CON, n = 7) groups. Before and after a 12-week training intervention involving endurance and resistance training, glucose tolerance (2-hour oral glucose tolerance test), exercise tolerance (cardiopulmonary exercise test), muscle strength (isokinetic dynamometer), heart function (echocardiography), glycated hemoglobin, body composition (dual-energy x-ray absorptiometry), and quality of life (EQ5D) were assessed.
  
  
  RESULTS
  At baseline, glucose levels 2 hours after glucose intake were elevated in both groups. Whereas area under the glucose curve did not change, area under the insulin curve decreased following training (EX, -13 ± 23% vs CON, +22 ± 33%; P < .05). Changes in the ratio of mitral peak velocity of early filling/early diastolic mitral annular velocity and waist-to-hip fat mass ratio were related to changes in the insulin curve. Exercise training resulted in improved oxygen uptake at the second ventilatory threshold (EX, +10 ± 5% vs CON, -8 ± 5%; P < .05) and isokinetic strength endurance of the upper leg (EX, +25 ± 9% vs CON, -6 ± 5%; P < 0.05). Lean body tissue was increased by 2.2 ± 0.5% in EX versus 0.2 ± 0.6% in CON (P < .05).
  
  
  CONCLUSIONS
  Our data suggest that exercise training attenuates worsening of glucose regulation typically seen in a stable CHF population.
authors.affiliation: Reval - Rehabilitation Research Center, Biomed - Biomedical Research Institute, Faculty of Medicine and Life Sciences (Ms Stevens and Drs Hansen, Dendale, Wens, and Eijnde) and I-BioStat (Dr Creemers), Hasselt University, Hasselt, Belgium; and Jessa Hospital, Heart Centre Hasselt, Hasselt, Belgium (Drs Hansen, Herbots, and Dendale).
authors.forename: An L M
authors.initials: AL
authors.lastname: Stevens
authors.forename: Dominique
authors.initials: D
authors.lastname: Hansen
authors.forename: Lieven
authors.initials: L
authors.lastname: Herbots
authors.forename: Inez
authors.initials: I
authors.lastname: Wens
authors.forename: An
authors.initials: A
authors.lastname: Creemers
authors.forename: Paul
authors.initials: P
authors.lastname: Dendale
authors.forename: Bert O
authors.initials: BO
authors.lastname: Eijnde
mesh_terms: D000368:Aged; D005080:Exercise Test / Q000379:methods; D005081:Exercise Therapy / Q000379:methods*; D005947:Glucose / Q000378:metabolism; D005951:Glucose Tolerance Test / Q000379:methods; D006442:Glycated Hemoglobin / Q000032:analysis; D006333:Heart Failure / Q000150:complications / Q000000981:diagnostic imaging / Q000534:rehabilitation*; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011236:Prediabetic State / Q000473:pathology; D014463:Ultrasonography
chemical_list: D005947:Glucose; D006442:Glycated Hemoglobin; D007328:Insulin; D020097:Natriuretic Peptide, Brain; C517652:hemoglobin A1c protein, human