Supplemental data
Results:
The following results section details the results of the cohort of recruits who completed only the moderate intensity phase.
Induction phase: Moderate intensity exercise
The following section details the results of the entire cohort who undertook the 12-week moderate intensity exercise program (n=115).
The moderate intensity exercise program was associated with an improvement in fitness and a decrease in body mass index (BMI), body surface area (BSA) and % body fat (all p<0.01) (Figure S2, Table S1). Diastolic blood pressure (DBP) and heart rate also reduced
significantly in response to a moderate intensity exercise program (both p<0.01). There was also a non-significant trend towards lower systolic blood pressure (SBP).
Left heart chamber adaptation to moderate intensity exercise
Structural and functional changes to the left heart are reported in Table S2. Moderate intensity exercise was associated with an increase in LV wall thickness, indexed LV end diastolic dimensions (LVEDD), LA volumes (LAV) and LV volumes (all p<0.01). Left ventricular mass (LVM) increased after moderate intensity exercise (p<0.01). At baseline, most participants had normal ventricular geometry (normal LVM (≤115g/m2) and normal relative wall thickness (≤0.42). After moderate intensity exercise there was an increase in the proportion of the cohort with eccentric remodeling (increased LVM >115g/m2, normal relative wall thickness) from 3% at baseline to 11% after moderate intensity exercise, however this was not statistically significant.
Moderate intensity exercise was associated with improved LV systolic function, with an increase in LV ejection fraction (LVEF) (p<0.05), stroke volume (p<0.01) and GLS (p<0.01).
GLS could not be analyzed in 5 of the 115 participants due to image quality or technical issues. Moderate intensity exercise was also associated with changes in LV diastolic function.
There was an increase in peak mitral valve inflow velocity (p<0.01), E/A ratio (p<0.05) and pulmonary vein S/D ratio (p<0.01) after moderate intensity exercise. There was no exercise- related change in the E/e’ ratio or the mitral inflow deceleration time.
Right heart chamber adaptation to moderate intensity exercise
Structural and functional changes in the right heart chambers are shown in Table S3.
Moderate intensity exercise was associated with an increase in RVEDA (p<0.01) and RV end diastolic dimensions (basal and mid-cavity) (both p<0.01). There was no significant
difference in RAV after moderate intensity exercise.
Moderate intensity exercise was associated with an increase in RV systolic function as measured by tricuspid annular plane excursion (TAPSE) and tissue doppler (S’) (both p<0.01). On the other hand, there was no change in fractional area change (FAC) and there was an increase in RV free wall strain after moderate intensity exercise (p<0.01).
