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

TY - JOUR

T1 - Insulin resistance

T2 - a potential new target for therapy in patients with heart failure

AU - Wong, Aaron K. F.

AU - ALZadjaii, Matlooba A.

AU - Choy, Anna-Maria J.

AU - Lang, Chim C.

PY - 2008

Y1 - 2008

N2 - 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.

AB - 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.

KW - chronic heart failure

KW - diabetes mellitus

KW - exercise

KW - insulin resistance

KW - metformin

KW - thiazolidinediones

KW - TYPE-2 DIABETES-MELLITUS

KW - TUMOR-NECROSIS-FACTOR

KW - DILATED CARDIOMYOPATHY

KW - LACTIC-ACIDOSIS

KW - GLUCOSE-UPTAKE

KW - PLASMA LEPTIN

KW - LIPOTOXIC CARDIOMYOPATHY

KW - ATHEROSCLEROSIS RISK

KW - CARDIAC DYSFUNCTION

KW - UNCOUPLING PROTEINS

U2 - 10.1111/j.1755-5922.2008.00053.x

DO - 10.1111/j.1755-5922.2008.00053.x

M3 - Article

C2 - 18786090

SN - 1755-5914

VL - 26

SP - 203

EP - 213

JO - Cardiovascular Therapeutics

JF - Cardiovascular Therapeutics

IS - 3

ER -