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Insulin resistance is highly prevalent and is associated with reduced exercise tolerance in nondiabetic patients with

Matlooba A AlZadjali1, Valerie Godfrey, Faisel Khan

  • 1University of Dundee, Ninewells Hospital and Medical School, United Kingdom.

Journal of the American College of Cardiology
|February 28, 2009
PubMed

Insights

Insulin resistance (IR) affects 61% of patients with chronic heart failure (CHF). This condition is linked to reduced exercise capacity and poorer health outcomes in individuals with CHF.

Area of Science:

  • Cardiology
  • Metabolic Disorders

Background:

  • Chronic heart failure (CHF) is increasingly recognized as a state of insulin resistance (IR).
  • The precise prevalence and clinical implications of IR in CHF remain incompletely defined.

Purpose of the Study:

  • To determine the prevalence of insulin resistance (IR) in nondiabetic patients with chronic heart failure (CHF).
  • To identify factors associated with IR in CHF.
  • To examine the relationship between IR and functional class, exercise capacity, and disease severity in CHF patients.

Main Methods:

  • Assessed insulin resistance using the fasting insulin resistance index (FIRI) in 129 consecutive CHF patients.
  • Conducted cardiopulmonary exercise testing.
  • Performed peripheral endothelial function testing using reactive hyperemia peripheral arterial tonometry (RH-PAT).

Main Results:

  • Identified a high prevalence of IR (61%) in the CHF cohort, defined by FIRI ≥ 2.7.
  • Found significant correlations between IR and waist circumference, triglycerides, HDL cholesterol, and leptin levels.
  • Observed that IR was associated with worsening New York Heart Association functional class, reduced exercise capacity, and impaired endothelial function.

Conclusions:

  • Insulin resistance is highly prevalent in nondiabetic patients with chronic heart failure.
  • IR in CHF patients is associated with decreased exercise capacity and poorer functional status.
Abstract

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