Exercise training improves insulin-stimulated myocardial glucose uptake in patients with dilated cardiomyopathy.

Abstract

BACKGROUND:

The effects of exercise training on myocardial substrate utilization have not previously been studied in patients with idiopathic dilated cardiomyopathy and mild heart failure.

METHODS AND RESULTS:

Myocardial glucose uptake was studied in 15 clinically stable patients with dilated cardiomyopathy (New York Heart Association class I-II, ejection fraction 34% +/- 8%) with the use of 2-[fluorine 18]fluoro-2-deoxy-d-glucose ([F-18]FDG) and positron emission tomography under euglycemic hyperinsulinemia. Eight of these patients participated in a 5-month endurance and strength training program, whereas seven patients served as nontrained subjects. Left ventricular function was assessed by 2-dimensional echocardiography before and after the intervention. After the training period, insulin-stimulated myocardial fractional [F-18]FDG uptake and glucose uptake rates were significantly increased in the anterior, lateral, and septal walls (P <.01) in the trained subjects but remained unchanged in the nontrained subjects. In the trained patients, whole-body insulin-stimulated glucose uptake was enhanced and serum free fatty acid levels were suppressed during hyperinsulinemia compared with the baseline study (P <.05). No changes were observed in the nontrained group.

CONCLUSIONS:

These results indicate that exercise training in patients with dilated cardiomyopathy improves insulin-stimulated myocardial glucose uptake. This improvement in glucose uptake may be indicative of a switch in myocardial preference to a more energy-efficient substrate.

• Authors: Kira Q Stolen, Jukka Kemppainen, Kari K Kalliokoski, Matti Luotolahti, Tapio Viljanen, Pirjo Nuutila, Juhani Knuuti
• Journal: Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology (J Nucl Cardiol) 2003 Sep-Oct Vol. 10 Issue 5 Pg. 447-55 ISSN: 1071-3581 [Print] United States
• PMID: 14569237 (Publication Type: Clinical Trial, Controlled Clinical Trial, Journal Article)

Chemical References

• Blood Glucose
• Insulin
• Radiopharmaceuticals
• Fluorodeoxyglucose F18

Topics

• Blood Glucose (analysis)
• Cardiomyopathy, Dilated (complications, diagnosis, metabolism, therapy)
• Echocardiography
• Exercise Test
• Exercise Therapy (methods)
• Female
• Fluorodeoxyglucose F18 (pharmacokinetics)
• Glucose Clamp Technique (methods)
• Humans
• Insulin
• Male
• Middle Aged
• Myocardium (metabolism)
• Radiopharmaceuticals (pharmacokinetics)
• Recovery of Function
• Treatment Outcome
• Ventricular Dysfunction, Left (diagnosis, etiology, metabolism, therapy)