Prevention of ischemic heart failure by exercise in spontaneously diabetic BB Wor rats subjected to insulin withdrawal

Poor metabolic control resulting from insulin withdrawal in chronic type 1 diabetic rats results in ischemic heart failure. In the present study, we determined whether heart failure occurs in acute type 1 diabetic rats following insulin withdrawal and if prior exercise training can prevent this dysfunction. Four-week-old diabetic prone BB Wor rats were either sedentary or moderately exercised by daily treadmill running. Training was discontinued at the onset of diabetes. Isolated working rat heart function was then assessed in the following groups: diabetic resistant, uncontrolled sedentary diabetic (USD), controlled sedentary diabetic (CSD), uncontrolled trained diabetic (UTD), and controlled trained diabetic (CTD) rats. To induce an uncontrolled state, insulin treatment was withheld for 24 hours. During increased metabolic demand and reperfusion following ischemia, heart rate, contractility, and cardiac output were depressed in hearts from USD animals. Treatment with insulin prevented the depressions in cardiac performance from occurring. Hearts from UTD rats perfused under these conditions showed comparable cardiac function to that seen in the controlled state. This occurred despite poor metabolic control, reflected by elevated levels of plasma glucose and free fatty acids. Our results indicate that metabolic deteriorations in acute diabetes result in ischemic heart failure. However, this cardiac dysfunction can be prevented with exercise training. (C) 2003 Elsevier Inc. All rights reserved.