Lack of effects of pioglitazone on cardiac function in patients with type 2 diabetes and evidence of left ventricular diastolic dysfunction: a tissue doppler imaging study

Cardiovascular Diabetology

Original Investigation

Nikolaos D Papamichael¹  Konstantinos Pappas¹  Demetrios Makriyiannis²  Chryssanthi Kanioglou³  Agathocles Tsatsoulis³  Kostas Liveris⁴  Nikolaos Kazakos⁴  Katerina Papathanassiou⁴  Katerina K Naka⁵  Lampros K Michalis⁵  Christos S Katsouras⁵ 

[1] Department of Cardiology, University of Ioannina, University Campus, 45 110, Ioannina, Greece;Department of Endocrinology, Hatzikosta General Hospital, Makrygianni Avenue, 45 001, Ioannina, Greece;Department of Endocrinology, University of Ioannina, University Campus, 45 110, Ioannina, Greece;Michaelidion Cardiac Center, University of Ioannina, University Campus, 45 110, Ioannina, Greece;Michaelidion Cardiac Center, University of Ioannina, University Campus, 45 110, Ioannina, Greece;Department of Cardiology, University of Ioannina, University Campus, 45 110, Ioannina, Greece;

关键词: Metformin;    Rosiglitazone;    Pioglitazone;    Glycaemic Control;    Tissue Doppler Image;   

DOI  :  10.1186/1475-2840-9-57

 received in 2010-07-27, accepted in 2010-09-23,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundThiazolidinediones, used for the treatment of patients with type 2 diabetes mellitus (DM2), are associated with an increased incidence of heart failure. We sought to investigate the effects of pioglitazone on novel echocardiographic indices of left ventricular (LV) diastolic function in DM2 patients with LV diastolic dysfunction (LVDD).MethodsEighty-eight asymptomatic DM2 patients on metformin and/or sulfonylureas, aged 64.5 ± 7.7 years, without known cardiovascular disease, with normal LV systolic function and evidence of LVDD were randomly assigned to pioglitazone 30 mg/day (n = 42) or an increase in dose of other oral agents (n = 39) for 6 months. All patients underwent transthoracic conventional and Tissue Doppler Imaging echocardiography at baseline and follow-up. The primary end-point was change in early diastolic velocity of the mitral annulus (E').ResultsImprovement of glycaemic control was similar in the 2 groups. A significant difference (p < 0.05) between the 2 groups was found in the treatment-induced changes in fasting insulin, the insulin resistance index HOMA, HDL cholesterol, triglycerides, diastolic blood pressure (all in favor of pioglitazone) and in body weight (increase with pioglitazone). No significant changes were observed in any echocardiographic parameter in either group and did not differ between groups (p = NS for all). E' increased non-significantly and to a similar extent in both groups (p = NS).ConclusionsIn asymptomatic DM2 patients with LVDD, the addition of pioglitazone to oral conventional treatment for 6 months does not induce any adverse or favorable changes in LV diastolic or systolic function despite improvements in glycaemic control, insulin sensitivity, lipid profile, and blood pressure.

【 授权许可】

Unknown   
© Naka et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.