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Insulin resistance in chronic heart failure
J W Swan1, C Walton, I F Godsland
1Wynn Institute for Metabolic Research, London, U.K.
European Heart Journal
|November 1, 1994
Summary
Patients with severe chronic heart failure exhibit significant insulin resistance and hyperinsulinaemia compared to healthy individuals. This metabolic dysfunction may worsen heart function and symptoms like fatigue.
Area of Science:
- Cardiology
- Metabolic Medicine
- Endocrinology
Background:
- Chronic heart failure (CHF) is associated with complex metabolic disturbances.
- Insulin resistance is increasingly recognized as a potential contributor to cardiovascular disease progression.
Purpose of the Study:
- To investigate insulin sensitivity abnormalities in patients with severe chronic heart failure.
- To compare glucose metabolism and insulin resistance between CHF patients and healthy controls.
Main Methods:
- Assessed glucose metabolism and insulin resistance in 10 male CHF patients and 10 matched controls.
- Utilized a 0.5 g.kg-1 intravenous glucose tolerance test (IVGTT).
- Measured glucose, insulin, and C-peptide concentrations, estimating insulin sensitivity via minimal modeling analysis.
Main Results:
- CHF patients showed similar fasting plasma glucose but significantly higher fasting insulin (P=0.002) and C-peptide (P=0.02) levels.
- The incremental plasma insulin response was significantly greater in CHF patients (P=0.004).
- Mean insulin sensitivity was 73% lower in heart failure patients (P=0.003), indicating significant insulin resistance.
Conclusions:
- Severe chronic heart failure is characterized by hyperinsulinaemia and insulin resistance.
- This insulin resistance may exacerbate myocardial dysfunction and clinical symptoms in CHF.
- Further research into interventions targeting insulin resistance in CHF is warranted.
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