[Assessment of left ventricular diastolic function with pioglitazone in type 2 diabetic patients].
OBJECTIVE
This study investigated the effect of pioglitazone, an insulin sensitizer, on left ventricular diastolic function in type 2 diabetic patients.


METHODS
Various echocardiographic parameters such as left ventricular ejection fraction, transmitral E/A ratio (E/A), deceleration time of E, isovolumetric relaxation time and left ventricular Tei index were measured. A total of 59 patients were enrolled in the ON-group, and the parameters were examined before and after pioglitazone administration (15-30 mg/day) for 6 months, and 9 patients in the OFF-group, and the parameters were examined before and 6 months after cessation of pioglitazone.


RESULTS
Average age of subjects was 61.5 years with an age range from 45 to 79 years. Left ventricular ejection fraction and brain natriuretic peptide were not significantly changed both in the ON-group and in the OFF-group. Pioglitazone significantly increased E/A (0.91 +/- 0.23 vs 0.99 +/- 0.24, p < 0.01)and decreased deceleration time of E (233.9 +/- 58.6 vs 209.9 +/- 38.3 msec, p < 0.01), isovolumetric relaxation time(91.5 +/- 13.6 vs 76.0 +/- 12.1 msec, p < 0.01)and left ventricular Tei index (0.38 +/- 0.11 vs 0.35 +/- 0.09, p < 0.01) in the ON-group. On the other hand, E/A (1.08 +/- 0.35 vs 0.88 +/- 0.20, p < 0.01) was significantly decreased and left ventricular Tei index (0.28 +/- 0.11 vs 0.33 +/- 0.11, p < 0.01) was significantly increased in the OFF-group.


CONCLUSIONS
Pioglitazone administration improves and cessation worsens left ventricular diastolic function.
Terui
Gen
G
Department of Cardiovascular Medicine, Akita Red Cross Hospital. gterui@archosp-1998.com
Goto
Takashi
T
Katsuta
Mitsuaki
M
Aoki
Isamu
I
D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology*; D003971:Diastole; D004452:Echocardiography; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008875:Middle Aged; D000077205:Pioglitazone; D045162:Thiazolidinediones / Q000627:therapeutic use*; D016277:Ventricular Function, Left
D007004:Hypoglycemic Agents; D045162:Thiazolidinediones; D000077205:Pioglitazone