Insulin resistance: a potential new target for therapy in patients with heart failure

Aaron K. F. Wong, Matlooba A. ALZadjaii, Anna-Maria J. Choy, Chim C. Lang

    Research output: Contribution to journalArticle

    26 Citations (Scopus)

    Abstract

    There is increasing evidence to Suggest, that chronic heart failure (CHF) is an insulin resistant (IR) state and that the degree of IR correlates with the severity and mortality of CHF. The pathophysiology of IR in CHF has yet to be fully defined. Additionally, it remains to be determined if IR is merely a marker reflecting the severity of Cl-IF or whether it contributes to the disease in CHF. If IR is truly a Culprit that worsens CHF, it will potentially be a new target for therapy as strategies that call reverse IR in CHF may potentially result in an improvement in symptoms and even mortality in these patients. However, there are concerns regarding file Use of certain insulin sensitizers, most notably, the thiazolidinediones (TZDs) which have been associated with increased risk of hospitalizations for CHF. Despite previous concerns of lactic acidosis (LA), there is now evidence that metformin may not only be safe but could potentially be Useful in the setting of CHF. There are now ongoing prospective studies, including the TAYSIDE Study, to determine if reversing IR with metformin will have beneficial effects in patients with CHF.

    Original languageEnglish
    Pages (from-to)203-213
    Number of pages11
    JournalCardiovascular Therapeutics
    Volume26
    Issue number3
    DOIs
    Publication statusPublished - 2008

    Keywords

    • chronic heart failure
    • diabetes mellitus
    • exercise
    • insulin resistance
    • metformin
    • thiazolidinediones
    • TYPE-2 DIABETES-MELLITUS
    • TUMOR-NECROSIS-FACTOR
    • DILATED CARDIOMYOPATHY
    • LACTIC-ACIDOSIS
    • GLUCOSE-UPTAKE
    • PLASMA LEPTIN
    • LIPOTOXIC CARDIOMYOPATHY
    • ATHEROSCLEROSIS RISK
    • CARDIAC DYSFUNCTION
    • UNCOUPLING PROTEINS

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