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The impact of lifestyle intervention on left atrial function in type 2 diabetes: results from the DIASTOLIC study

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posted on 2024-05-22, 13:00 authored by A Alfuhied, GS Gulsin, L Athithan, EM Brady, K Parke, Joseph HensonJoseph Henson, E Redman, AM Marsh, T Yates, MJ Davies, GP McCann, A Singh
Aerobic exercise training and low energy diets have been shown to improve left ventricular remodelling and diastolic function in adults with type 2 diabetes (T2D), albeit with differential effects. The impact of these lifestyle interventions on left atrial (LA) function, however, has not previously been reported. The DIASTOLIC study was a prospective, randomised, open-label, blind endpoint trial, in which 90 people with obesity and T2D and no prevalent cardiovascular disease were randomised to a 12-week intervention of: (i) routine care, (ii) aerobic exercise training, or (iii) low energy (≈ 810 kcal/day) meal replacement plan (MRP). Cardiac magnetic resonance (CMR) imaging was performed pre- and post-intervention. Image analysis included LA volumes (LAV), emptying fraction (LAEF), and LA strain (LAS) corresponding to LA reservoir (LAS-r), conduit (LAS-cd), and booster pump (LAS-bp) function. 73 participants with T2D (mean age 50 ± 6 years, 62% male, body mass index (BMI) 36.1 ± 5.3 kg/m2) completed the trial and had analysable LA images. There was no significant change in CMR measured LA volumetric function (LAV/LAEF) in any group. The routine care group showed no significant change in BMI or LAS. In the MRP group, there were significant reductions in BMI (4.5 kg/m2) and a significant increase in LAS-r and LAS-bp (29.9 ± 7.0 to 32.3 ± 7.0%, p = 0.036 and 14.6 ± 5.3 to 17.2 ± 3.7%, p = 0.034). The exercise group showed a small reduction in BMI (0.49 kg/m2), with no significant change in LAS. Compared to routine care, weight loss via a 12-week MRP, led to improvements in LA filling and contractile function in adults with T2D and obesity. However, these within-group changes were not statistically significant on between-group comparison. ClinicalTrials.gov Identifier: NCT02590822.

Funding

The DIASTOLIC study was funded by NIHR through a career development fellowship (G McCann, CDF 2014-07-045). AA is funded by King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.

History

Author affiliation

College of Life Sciences/Cardiovascular Sciences & Population Health Sciences

Version

  • VoR (Version of Record)

Published in

International Journal of Cardiovascular Imaging

Volume

38

Issue

9

Pagination

2013 - 2023

Publisher

Springer Science and Business Media LLC

issn

1569-5794

eissn

1573-0743

Copyright date

2022

Available date

2024-05-22

Spatial coverage

United States

Language

en

Deposited by

Dr Anvesha Singh

Deposit date

2024-05-09

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