Abstract 16895: Interrelation of Exercise Training, Cardiorespiratory Fitness, and Cardiac Biomarkers in Patients Enrolled in the Health Benefits of Aerobic and Resistance Training in Individuals With Type 2 Diabetes Study

Abstract

Introduction: Low cardiorespiratory fitness (CRF) and elevated biomarker levels of myocardial injury and inflammation are both associated with heart failure (HF) risk. While exercise training (ET) is associated with improvement in CRF, the interrelationships among CRF, cardiac biomarkers, and ET are not well established. Methods: Participants of the Health Benefits of Aerobic and Resistance Training in Individuals with Type 2 Diabetes study were included. High-sensitivity cardiac troponin T (hs-cTnT), growth differentiation factor-15 (GDF-15), N-terminal pro-B-type natriuretic peptide (NT-proBNP), and peak oxygen uptake (VO 2peak ) were assessed at baseline and at 9 months on completion of ET. Longitudinal change in cardiac biomarkers across treatment groups (control versus ET) were assessed using paired t-tests. Multivariable-adjusted linear regression was performed to identify factors associated with follow-up cardiac biomarkers and ΔVO 2peak . Results: This study included 166 participants randomized to control (n = 31) and ET groups (n = 135). There was no significant change in hs-cTnT or NT-proBNP from baseline to follow-up among ET and control group participants. GDF-15 increased among participants randomized to the control (P = 0.01) but not the ET group. In adjusted analysis, each ET regimen was independently associated with lower follow-up GDF-15 but not with change in other biomarkers ( Table ). ΔVO 2peak was not associated with any follow-up biomarker level in adjusted analysis. Among individuals in the ET group, baseline hs-cTnT and GDF-15 were each significantly associated with ΔVO 2peak [per 1-unit higher log(hs-cTnT): β= -0.18 (95% CI = -0.31, -0.05); per 1-unit higher log(GDF-15): β = 0.08 (95% CI = 0.01, 0.15)]. Conclusions: Among patients with type 2 diabetes, ET was associated with reduction in GDF-15 but not with change in other biomarkers. Baseline hs-cTnT and GDF-15 were each independent predictors of CRF change in response to ET.