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Abstract Background The incidence of diabetes mellitus in younger adults is rising over the years. The diabetic population has an increased risk of developing heart failure, and diabetic individuals with heart failure have four times greater mortality rate. Studies results about exercise effect on left ventricular function in type 2 diabetes mellitus are heterogenous. Objective This review aimed to analyze the effects of physical exercise on left ventricular dysfunction in type 2 diabetes mellitus (T2DM). Methods Only randomized clinical trials with humans published in English were included. Inclusion criteria were studies with type 2 diabetes patients, physical exercise, control group and left ventricular function. Exclusion criteria were studies with animals, children, teenagers, elderly individuals and athletes, presence of diet intervention, and patients with type 1 diabetes, cancer, cardiac, pulmonary, or neurological diseases. Electronic databases PubMed, Web of Science, Cochrane, and Scopus were last searched in September 2021. Risk of bias was assessed by the Physiotherapy Evidence Database (PEDro) scale. Results Five studies were included, representing 314 diabetic individuals submitted to resistance and aerobic exercise training. Of the variables analyzed, physical exercise improved peak torsion (PTo), global longitudinal strain, global strain rate (GSR), time to peak untwist rate (PUTR), early diastolic filling rate (EDFR) and peak early diastolic strain rate (PEDSR). Conclusion To our knowledge, this is the first systematic review on the effects of exercise on left ventricular function in T2DM including only randomized clinical trials with humans. Physical exercise seems to improve systolic and diastolic strain, twist, and torsion. High intensity exercise was reported to be superior to moderate intensity exercise in one study. This review was limited by the small number of studies and their heterogeneity regarding exercise protocols, follow-up period, exercise supervision and left ventricular function variables analyzed. This review was registered in PROSPERO (CRD42021234964).
RESUMEN
O objetivo do estudo foi analisar e comparar as respostas agudas de variáveis clínicas e funcionais, após uma sessão de exercício de força máxima de contração concêntrica versus excêntrica. Foram avaliados 46 indivíduos do sexo masculino, divididos aleatoriamente em dois grupos, conforme o tipo de exercício. Na comparação entre os grupos não houve diferenças significativas. Porém, na análise de cada grupo observou-se aumento da sensação de dor (EVA) e da percepção de esforço (escala de Borg) e incrementos nas medidas da circunferência da coxa (grupo excêntrico: 10% [p<0,001], 20% [p<0,001] e 30% [p<0,05]; grupo concêntrico: 40% [p<0,01]). Para o algômetro, apenas o grupo concêntrico apresentou menor limiar (p<0,01). Pode-se inferir que estímulos controlados até 100% não são agressivos e limitantes e futuros estudos podem incluir análises de marcadores de lesão.
The aim of the study was to analyze and compare the acute responses of clinical and functional variables after a maximum force exercise of eccentric versus concentric contraction. We evaluated 46 male subjects were randomly divided into two groups according to the type of exercise. Comparing the groups no significant differences, but the analysis of each group, there was an increased sensation of pain (VAS), perceived exertion (Borg scale) and increases in measures of thigh circumference (eccentric group: 10% (p<0.001) 20% (p<0.001) 30% (p<0.05) and concentric to the group: measured with 40% p<0.01) for the algometer, only concentric group showed lower threshold (p<0.01). It can be inferred that stimuli controlled up to 100% are not aggressive and limiting, and future studies may include analysis of injury markers.
El objetivo del estudio fue analizar y comparar las respuestas agudas de las variables clínica y funcional después de un ejercicio de fuerza máxima de contracción excéntrica frente concéntrica. Se evaluaron 46 sujetos masculinos, divididos aleatoriamente en dos grupos, de acuerdo con el tipo de ejercicio. La comparación de los grupos no hubo diferencias significativas, pero el análisis de cada grupo, se produjo un aumento de la sensación de dolor (VAS), el esfuerzo percibido (escala de Borg) y el aumento de las medidas de la circunferencia del muslo (grupo excéntrico: 10% (p<0,001) 20% (p<0,001) 30% (p<0,05) y concéntrico con el grupo: medido con 40% p<0,01) para algómetro, sólo el grupo concéntrico tuvo umbral inferior (p<0,01). Se puede inferir que los estímulos controlados hasta el 100% no son agresivos y limitante, y los estudios futuros pueden incluir análisis de marcadores de lesión.