title: Exercise Training Normalizes Timing of Left Ventricular Untwist Rate, but Not Peak Untwist Rate, in Individuals with Type 2 Diabetes and Diastolic Dysfunction: A Pilot Study.
abstract: There is limited information regarding the role of left ventricular (LV) twist and the effect of exercise in type 2 diabetes (T2D). The aim of this study was to compare LV twist parameters in patients with T2D versus healthy control subjects and the effects of high-intensity interval exercise (HIIE) and moderate-intensity exercise (MIE) on LV twist in patients with T2D with diastolic dysfunction.
  
  
  
  This study, which included both prospective and retrospective components, included 47 patients with T2D and diastolic dysfunction and 37 healthy individuals. Patients with T2D were randomized to HIIE (4 × 4 min at 90%-95% of maximal heart rate, three times a week, 120 min/wk; n = 24) or MIE (210 min/wk; n = 23) for 12 weeks and examined with echocardiography (LV twist by speckle-tracking method) at baseline and posttest. The control subjects received no intervention and were matched according to age, gender, and body mass index to those completing the intervention.
  
  
  
  In total, 37 subjects completed 12 weeks of MIE (n = 17) or HIIE (n = 20). LV peak untwist rate (UTR) was similar in patients with T2D and control subjects (P ˃ .05). At baseline, LV peak UTR, relative to total diastolic period, occurred 5.8 percentage points later in patients with T2D compared with control subjects (P = .004). Time to peak UTR was shortened by 6.5 percentage points (P = .002) and 7.7 percentage points (P < .001) after MIE and HIIE, respectively. Time to peak UTR was similar to that in control subjects after exercise interventions.
  
  
  
  In patients with T2D and diastolic dysfunction, LV peak UTR was similar, but time to peak LV UTR was delayed compared with control subjects. Twelve weeks of endurance exercise normalized the timing of UTR.
authors.affiliation: K. G. Jebsen Centre of Exercise in Medicine at the Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Siri Marte
authors.initials: SM
authors.lastname: Hollekim-Strand
authors.affiliation: K. G. Jebsen Centre of Exercise in Medicine at the Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Sigve Fredrik
authors.initials: SF
authors.lastname: Høydahl
authors.affiliation: Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Turid
authors.initials: T
authors.lastname: Follestad
authors.affiliation: Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and technology, Trondheim, Norway; Department of Medicine, Levanger Hospital, Nord-Trøndelag Health Trust, Levanger, Norway.
authors.forename: Håvard
authors.initials: H
authors.lastname: Dalen
authors.affiliation: Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway; Department of Endocrinology, St Olav's Hospital, Trondheim, Norway.
authors.forename: Marit Rokne
authors.initials: MR
authors.lastname: Bjørgaas
authors.affiliation: K. G. Jebsen Centre of Exercise in Medicine at the Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Ulrik
authors.initials: U
authors.lastname: Wisløff
authors.affiliation: K. G. Jebsen Centre of Exercise in Medicine at the Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway. Electronic address: charlotte.b.ingul@ntnu.no.
authors.forename: Charlotte Björk
authors.initials: CB
authors.lastname: Ingul
mesh_terms: D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000000981:diagnostic imaging / Q000628:therapy*; D004452:Echocardiography / Q000379:methods*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D064797:Physical Conditioning, Human / Q000379:methods*; D010865:Pilot Projects; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000628:therapy*
keywords: Diastolic dysfunction; Exercise training; Left ventricular twist; Speckle-tracking echocardiography; Type 2 diabetes