Fournier Sara B, Donley David A, Bonner Daniel E, Devallance Evan, Olfert I Mark, Chantler Paul D
1Department of Human Performance and Applied Sciences, Division of Exercise Physiology, School of Medicine, West Virginia University, Morgantown, WV; and 2Center for Cardiovascular and Respiratory Sciences, School of Medicine, West Virginia University, Morgantown, WV.
Med Sci Sports Exerc. 2015 Jan;47(1):2-11. doi: 10.1249/MSS.0000000000000388.
The metabolic syndrome (MetS) is associated with threefold increased risk of cardiovascular (CV) morbidity and mortality, which is partly due to a blunted CV reserve capacity, reflected by a reduced peak exercise left ventricular (LV) contractility and aerobic capacity and a blunted peak arterial-ventricular coupling. To date, no study has examined whether aerobic exercise training in MetS can reverse peak exercise CV dysfunction. Furthermore, examining how exercise training alters CV function in a group of individuals with MetS before the development of diabetes and/or overt CV disease can provide insights into whether some of the pathophysiological CV changes can be delayed/reversed, lowering their CV risk. The objective of this study was to examine the effects of 8 wk of aerobic exercise training in individuals with MetS on resting and peak exercise CV function.
Twenty participants with MetS underwent either 8 wk of aerobic exercise training (MetS-ExT, n = 10) or remained sedentary (MetS-NonT, n = 10) during this period. Resting and peak exercise CV function was characterized using Doppler echocardiography and gas exchange.
Exercise training did not alter resting LV diastolic or systolic function and arterial-ventricular coupling in MetS. In contrast, at peak exercise, an increase in LV contractility (40%, P < 0.01), cardiac output (28%, P < 0.05), and aerobic capacity (20%, P < 0.01), but a reduction in vascular resistance (30%, P < 0.05) and arterial-ventricular coupling (27%, P < 0.01), were noted in the MetS-ExT but not in the MetS-NonT group. Furthermore, an improvement in lifetime risk score was also noted in the MetS-ExT group.
These findings have clinical importance because they provide insight that some of the pathophysiological changes associated with MetS can be improved and can lower the risk of CV disease.
代谢综合征（MetS）与心血管（CV）发病和死亡风险增加两倍相关，部分原因是CV储备能力减弱，表现为运动高峰时左心室（LV）收缩力降低、有氧运动能力下降以及动脉-心室耦合减弱。迄今为止，尚无研究探讨MetS患者进行有氧运动训练是否能逆转运动高峰时的CV功能障碍。此外，研究运动训练如何改变一组在糖尿病和/或明显CV疾病发生之前患有MetS的个体的CV功能，可深入了解某些病理生理CV变化是否可以延迟/逆转，从而降低其CV风险。本研究的目的是探讨8周有氧运动训练对MetS患者静息和运动高峰时CV功能的影响。
20名MetS患者在此期间接受了8周的有氧运动训练（MetS-ExT组，n = 10）或保持久坐不动（MetS-NonT组，n = 10）。使用多普勒超声心动图和气体交换来表征静息和运动高峰时的CV功能。
运动训练未改变MetS患者的静息LV舒张或收缩功能以及动脉-心室耦合。相反，在运动高峰时，MetS-ExT组的LV收缩力增加（40%，P < 0.01）、心输出量增加（28%，P < 0.05）、有氧运动能力增加（20%，P < 0.01），但血管阻力降低（30%，P < 0.05）和动脉-心室耦合降低（27%，P < 0.01），而MetS-NonT组未出现这些变化。此外，MetS-ExT组的终生风险评分也有所改善。
这些发现具有临床意义，因为它们表明与MetS相关的一些病理生理变化可以得到改善，并可降低CV疾病的风险。
