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Pioglitazone Improves Left Ventricular Diastolic Function in Subjects With Diabetes
Geoffrey D Clarke1,2, Carolina Solis-Herrera1, Marjorie Molina-Wilkins1
1Diabetes Division, University of Texas Health Science Center, San Antonio, TX.
Pioglitazone significantly enhances myocardial insulin sensitivity and improves both diastolic and systolic left ventricular (LV) function in patients with type 2 diabetes (T2D). These improvements in cardiac function are closely linked to increased insulin sensitivity in the heart.
Area of Science:
- Cardiology
- Endocrinology
- Metabolic Diseases
Background:
- Type 2 diabetes (T2D) is associated with impaired myocardial insulin sensitivity and cardiac dysfunction.
- Left ventricular (LV) dysfunction is a common complication in patients with T2D.
Purpose of the Study:
- To investigate the impact of pioglitazone on myocardial insulin sensitivity.
- To assess the effects of pioglitazone on left ventricular (LV) function in patients with T2D.
Main Methods:
- A euglycemic insulin clamp was performed on 12 T2D patients and 12 controls.
- Myocardial glucose uptake (MGU) and perfusion were measured using positron emission tomography.
- LV function and diastolic parameters (E/A ratio) were assessed via magnetic resonance imaging before and after 24 weeks of pioglitazone treatment.
Main Results:
- Pioglitazone reduced HbA1c and blood pressure, while increasing whole-body glucose uptake by 71% in T2D patients.
- Myocardial glucose uptake (MGU) increased by 75% and myocardial perfusion by 16% with pioglitazone treatment.
- Significant improvements were observed in LV diastolic function (E/A ratio, filling rate) and systolic function (ejection fraction, stroke volume).
Conclusions:
- Pioglitazone effectively improves whole-body and myocardial insulin sensitivity in T2D.
- The drug enhances both diastolic and systolic left ventricular (LV) function in T2D patients.
- Improved myocardial insulin sensitivity and diastolic function are strongly correlated, suggesting a key mechanism for cardiac benefits.
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