title: Effects of lifestyle intervention on left ventricular regional myocardial function in metabolic syndrome patients from the RESOLVE randomized trial.
abstract: OBJECTIVE
  The purpose of our study was to determine the effect of lifestyle intervention on left ventricular (LV) regional myocardial function in patients with metabolic syndrome (MetS) and investigate the relationships of the changes in myocardial function to changes in epicardial adipose tissue (EAT), inflammatory profile and MetS components.
  
  
  METHODS
  Eighty-seven MetS patients were enrolled in a 6month lifestyle intervention program based on dietary management and increased physical activity, and compared with 44 aged and sex-matched healthy controls. MetS individuals were allocated to different groups randomized (computer-generated randomization) on exercise modalities (high-intensity dominant resistance or aerobic training, and moderate-intensity of both modes). EAT was measured by transthoracic echocardiography and LV longitudinal strains and strain rates were obtained using vector velocity imaging. Blood chemistry allowed assessments of adipocytokines (TNF-α: tumor necrosis factor α, PAI active: active plasminogen activator inhibitor-1 and adiponectin) and glucose tolerance markers.
  
  
  RESULTS
  Regardless of exercise training modalities, lifestyle intervention improved significantly LV strains and strain rates (p<0.001) as well as metabolic and inflammatory profiles. Stepwise multiple regression analyses revealed EAT (β=0.73, p<0.01), log adiponectin (β=-0.13, p<0.05) and log TNF-α (β=0.15, p<0.05) as independent predictors of LV longitudinal strain (R(2)=0.74, p<0.001) while myocardial function improvement consecutive to lifestyle intervention was explained by EAT changes only (R(2)=0.54, p<0.001).
  
  
  CONCLUSIONS
  The mechanisms through which regional myocardial function is impaired in MetS and improved consecutive to intervention involved EAT, possibly via paracrine effects of adipocytokines. EAT should be considered as a future therapeutic target of interest in the treatment of metabolic-related cardiac diseases.
authors: EA4278 LaPEC, Laboratory of Cardiovascular Pharm-Ecology, Avignon University, Avignon, France.
authors: Juan
authors: J
authors: Serrano-Ferrer
authors: Australian Catholic University, Faculty of Health, School of Exercise Science, East Melbourne, Victoria, Australia.
authors: Edward
authors: E
authors: Crendal
authors: EA4278 LaPEC, Laboratory of Cardiovascular Pharm-Ecology, Avignon University, Avignon, France.
authors: Guillaume
authors: G
authors: Walther
authors: EA4278 LaPEC, Laboratory of Cardiovascular Pharm-Ecology, Avignon University, Avignon, France.
authors: Agnes
authors: A
authors: Vinet
authors: Australian Catholic University, Faculty of Health, School of Exercise Science, East Melbourne, Victoria, Australia; EA3533 AME2P, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological Conditions, Clermont Auvergne University, Clermont-Ferrand, France; Preventive and Occupational Medicine, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France.
authors: Frédéric
authors: F
authors: Dutheil
authors: Australian Catholic University, Faculty of Health, School of Exercise Science, East Melbourne, Victoria, Australia.
authors: Geraldine
authors: G
authors: Naughton
authors: EA3533 AME2P, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological Conditions, Clermont Auvergne University, Clermont-Ferrand, France.
authors: Bruno
authors: B
authors: Lesourd
authors: EA3533 AME2P, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological Conditions, Clermont Auvergne University, Clermont-Ferrand, France.
authors: Robert
authors: R
authors: Chapier
authors: Australian Catholic University, Faculty of Health, School of Exercise Science, East Melbourne, Victoria, Australia; EA3533 AME2P, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological Conditions, Clermont Auvergne University, Clermont-Ferrand, France.
authors: Daniel
authors: D
authors: Courteix
authors: EA4278 LaPEC, Laboratory of Cardiovascular Pharm-Ecology, Avignon University, Avignon, France; Australian Catholic University, Faculty of Health, School of Exercise Science, East Melbourne, Victoria, Australia. Electronic address: philippe.obert@univ-avignon.fr.
authors: Philippe
authors: P
authors: Obert
mesh_terms: D015502:Absorptiometry, Photon; D054392:Adipokines / Q000378:metabolism; D000273:Adipose Tissue / Q000378:metabolism / Q000503:physiopathology*; D001823:Body Composition; D004032:Diet; D004452:Echocardiography; D015444:Exercise; D005081:Exercise Therapy; D005260:Female; D018149:Glucose Intolerance / Q000378:metabolism; D006801:Humans; D008019:Life Style; D008297:Male; D024821:Metabolic Syndrome / Q000000981:diagnostic imaging / Q000178:diet therapy / Q000503:physiopathology*; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000000981:diagnostic imaging / Q000178:diet therapy / Q000503:physiopathology; D010496:Pericardium / Q000378:metabolism / Q000503:physiopathology; D016896:Treatment Outcome; D016277:Ventricular Function, Left
chemical_list: D054392:Adipokines
keywords: Epicardial fat; Inflammation; Lifestyle intervention; Metabolic syndrome; Myocardial dysfunction