title: Determinants of Improvement In Left Ventricular Diastolic Function Following a 1-Year Lifestyle Modification Program in Abdominally Obese Men with Features of the Metabolic Syndrome.
abstract: Abdominal obesity and presence of the metabolic syndrome (MetS) are associated with cardiac abnormalities. Among those, left ventricular diastolic dysfunction (LVDD) is the most frequently encountered in clinical practice. Few studies evaluated the reversibility of LVDD by an approach promoting lifestyle modifications in abdominally obese subjects with MetS.
  
  
  
  We assessed the impact of a 1-year lifestyle modification program combining nutritional and physical activity counseling on LVDD and metabolic profile of abdominally obese men with MetS. Echocardiograms, oral glucose tolerance test, lipids profile, dual energy X-ray absorptiometry, computed tomography scans (visceral obesity assessment), heart rate variability (HRV), as well as maximal and submaximal exercise tests were performed in participants before and after a 1-year program combining healthy eating and a physical activity/exercise program.
  
  
  
  Fifty-one abdominally obese men participated in this study. At baseline, 86% of the participants had LVDD (n = 44). After the 1-year program, LVDD improved in 57% of participants (n = 29, P < 0.0001). All metabolic, adiposity, and exercise tolerance measures improved from baseline (P < 0.0001), but were not associated with improvement in LVDD. Participants who improved LVDD had better exercise performance at baseline. Exercise tolerance during the submaximal exercise test, parasympathetic cardiac autonomic activity, and fasting insulin predicted 50% of LVDD improvements.
  
  
  
  There was a significant improvement in LVDD after a 1-year lifestyle intervention program in abdominally obese men with MetS, such an improvement being associated with increased exercise tolerance, enhanced HRV, and reduced insulin levels.
authors.affiliation: 1 Centre de recherche , Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada .|2 Faculté de Pharmacie, Université Laval , Québec, Canada .
authors.forename: Jacinthe
authors.initials: J
authors.lastname: Leclerc
authors.affiliation: 1 Centre de recherche , Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada .|3 Faculté de médecine, Université Laval , Québec, Canada .
authors.forename: Marie
authors.initials: M
authors.lastname: Arsenault
authors.affiliation: 1 Centre de recherche , Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada .|4 Département de kinésiologie, Faculté de médecine, Université Laval , Québec, Canada .
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Després
authors.affiliation: 1 Centre de recherche , Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada .|4 Département de kinésiologie, Faculté de médecine, Université Laval , Québec, Canada .
authors.forename: Patrice
authors.initials: P
authors.lastname: Brassard
authors.affiliation: 1 Centre de recherche , Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada .|2 Faculté de Pharmacie, Université Laval , Québec, Canada .
authors.forename: Valérie
authors.initials: V
authors.lastname: Gaudreault
authors.affiliation: 3 Faculté de médecine, Université Laval , Québec, Canada .|5 Centre Hospitalier Universitaire de Québec-Université Laval , Québec, Canada .
authors.forename: Jean
authors.initials: J
authors.lastname: Bergeron
authors.affiliation: 1 Centre de recherche , Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada .|3 Faculté de médecine, Université Laval , Québec, Canada .
authors.forename: Natalie
authors.initials: N
authors.lastname: Alméras
authors.affiliation: 4 Département de kinésiologie, Faculté de médecine, Université Laval , Québec, Canada .
authors.forename: Angelo
authors.initials: A
authors.lastname: Tremblay
authors.affiliation: 1 Centre de recherche , Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada .|2 Faculté de Pharmacie, Université Laval , Québec, Canada .
authors.forename: Audrey
authors.initials: A
authors.lastname: Auclair
authors.affiliation: 1 Centre de recherche , Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada .|3 Faculté de médecine, Université Laval , Québec, Canada .|6 Centre Hospitalier de Lévis , Québec, Québec, Canada .
authors.forename: Marie-Kristelle
authors.initials: MK
authors.lastname: Ross
authors.affiliation: 1 Centre de recherche , Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada .|3 Faculté de médecine, Université Laval , Québec, Canada .|5 Centre Hospitalier Universitaire de Québec-Université Laval , Québec, Canada .
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Denault-Bissonnette
authors.affiliation: 1 Centre de recherche , Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada .|2 Faculté de Pharmacie, Université Laval , Québec, Canada .
authors.forename: Paul
authors.initials: P
authors.lastname: Poirier
mesh_terms: D000328:Adult; D000368:Aged; D003971:Diastole; D037001:Directive Counseling; D004452:Echocardiography; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D056128:Obesity, Abdominal / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D040242:Risk Reduction Behavior; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D016277:Ventricular Function, Left / Q000502:physiology*; D061217:Weight Reduction Programs / Q000379:methods*
keywords: exercise; left ventricular diastolic dysfunction; lifestyle intervention; metabolic syndrome