PMID- 26687984
OWN - NLM
STAT- MEDLINE
DCOM- 20171109
LR  - 20181113
IS  - 1532-8414 (Electronic)
IS  - 1071-9164 (Print)
IS  - 1071-9164 (Linking)
VI  - 22
IP  - 7
DP  - 2016 Jul
TI  - Response to Exercise Training and Outcomes in Patients With Heart Failure and 
      Diabetes Mellitus: Insights From the HF-ACTION Trial.
PG  - 485-91
LID - S1071-9164(15)01216-6 [pii]
LID - 10.1016/j.cardfail.2015.12.007 [doi]
AB  - BACKGROUND: In HF-ACTION (Heart Failure: A Controlled Trial Investigating 
      Outcomes of Exercise Training), exercise training improved functional capacity in 
      heart failure with reduced ejection fraction (HFrEF). Previous studies have 
      suggested that diabetes mellitus (DM) may be associated with an attenuated 
      response to exercise. We explored whether DM attenuated the improvement in 
      functional capacity with exercise. METHODS AND RESULTS: HF-ACTION randomized 2331 
      patients with HFrEF to medical therapy with or without exercise training over a 
      median follow-up of 2.5 years. We examined the interaction between DM and 
      exercise response measured by change in 6-minute walk distance (6MWD) and peak 
      VO2. We also examined outcomes by DM status. In HF-ACTION, 748 (32%) patients had 
      DM. DM patients had lower functional capacity at baseline and had lower exercise 
      volumes at 3 months. There was a significant interaction between DM status and 
      exercise training for change in peak VO2 (interaction P = .02), but not 6MWD. In 
      the exercise arm, DM patients had a smaller mean increase in peak VO2 than non-DM 
      patients (P = .03). There was no interaction between DM and exercise on clinical 
      outcomes. After risk adjustment, DM was associated with increased all-cause 
      mortality/hospitalization (P = .03). CONCLUSIONS: In HF-ACTION, DM was associated 
      with lower baseline functional capacity, an attenuated improvement in peak VO2, 
      and increased hospitalizations.
CI  - Copyright (c) 2015 Elsevier Inc. All rights reserved.
FAU - Banks, Adam Z
AU  - Banks AZ
AD  - Duke University Medical Center, Durham, North Carolina. Electronic address: 
      adam.z.banks@duke.edu.
FAU - Mentz, Robert J
AU  - Mentz RJ
AD  - Duke University Medical Center, Durham, North Carolina; Duke Clinical Research 
      Institute, Durham, North Carolina.
FAU - Stebbins, Amanda
AU  - Stebbins A
AD  - Duke Clinical Research Institute, Durham, North Carolina.
FAU - Mikus, Catherine R
AU  - Mikus CR
AD  - Duke University Medical Center, Durham, North Carolina.
FAU - Schulte, Phillip J
AU  - Schulte PJ
AD  - Duke Clinical Research Institute, Durham, North Carolina.
FAU - Fleg, Jerome L
AU  - Fleg JL
AD  - National Heart, Lung, and Blood Institute, Bethesda, Maryland.
FAU - Cooper, Lawton S
AU  - Cooper LS
AD  - National Heart, Lung, and Blood Institute, Bethesda, Maryland.
FAU - Leifer, Eric S
AU  - Leifer ES
AD  - National Heart, Lung, and Blood Institute, Bethesda, Maryland.
FAU - Badenhop, Dalynn T
AU  - Badenhop DT
AD  - University of Toledo Medical Center, Toledo, Ohio.
FAU - Keteyian, Steven J
AU  - Keteyian SJ
AD  - Henry Ford Hospital, Detroit, Michigan.
FAU - Pina, Ileana L
AU  - Pina IL
AD  - Montefiore-Einstein Medical Center, New York, New York.
FAU - Kitzman, Dalane W
AU  - Kitzman DW
AD  - Wake Forest School of Medicine, Winston Salem, North Carolina.
FAU - Fiuzat, Mona
AU  - Fiuzat M
AD  - Duke University Medical Center, Durham, North Carolina; Duke Clinical Research 
      Institute, Durham, North Carolina.
FAU - Whellan, David J
AU  - Whellan DJ
AD  - Thomas Jefferson University, Philadelphia, Pennsylvania.
FAU - Kraus, William E
AU  - Kraus WE
AD  - Duke University Medical Center, Durham, North Carolina.
FAU - O'Connor, Christopher M
AU  - O'Connor CM
AD  - Duke University Medical Center, Durham, North Carolina; Duke Clinical Research 
      Institute, Durham, North Carolina.
LA  - eng
GR  - U01 HL063747/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20151211
PL  - United States
TA  - J Card Fail
JT  - Journal of cardiac failure
JID - 9442138
SB  - IM
MH  - Aged
MH  - Diabetes Mellitus/physiopathology/*therapy
MH  - *Exercise Therapy
MH  - Exercise Tolerance
MH  - Female
MH  - Heart Failure/physiopathology/*therapy
MH  - Hospitalization
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Patient Compliance
MH  - Treatment Outcome
PMC - PMC4903090
MID - NIHMS744402
OTO - NOTNLM
OT  - Diabetes mellitus
OT  - chronic heart failure
OT  - functional capacity
COIS- Disclosures: The other authors report no relevant conflicts of interest or 
      relationships with industry.
EDAT- 2015/12/22 06:00
MHDA- 2017/11/10 06:00
PMCR- 2017/07/01
CRDT- 2015/12/22 06:00
PHST- 2015/05/19 00:00 [received]
PHST- 2015/11/25 00:00 [revised]
PHST- 2015/12/01 00:00 [accepted]
PHST- 2015/12/22 06:00 [entrez]
PHST- 2015/12/22 06:00 [pubmed]
PHST- 2017/11/10 06:00 [medline]
PHST- 2017/07/01 00:00 [pmc-release]
AID - S1071-9164(15)01216-6 [pii]
AID - 10.1016/j.cardfail.2015.12.007 [doi]
PST - ppublish
SO  - J Card Fail. 2016 Jul;22(7):485-91. doi: 10.1016/j.cardfail.2015.12.007. Epub 
      2015 Dec 11.