title: Interactions of glucose metabolism and chronic heart failure.
abstract: BACKGROUND
  We evaluated insulin sensitivity and beta cell function in patients with chronic heart failure (CHF), and investigated a possible correlation of these metabolic parameters with specific biomarkers of heart failure. Additionally, we investigated the effects of two angiotensin receptor blockers (ARBs), namely telmisartan and candesartan, that were administered over a 5 month treatment period, as additional therapy to standard care.
  
  
  RESULTS
  The study group consisted of 94 CHF patients. Insulin sensitivity (OGIS index) and insulin secretion parameters were investigated by frequently sampled oral glucose tolerance tests and consecutive mathematical modelling. In total, 94.6 % of patients had clinically overt diabetes, impaired glucose tolerance or insulin resistance at the time of enrolment HbA1c was found to correlate to NT-proBNP, MR-proADM, CT-proET-1, and MR-proANP, but not to Copeptin. NT-proBNP correlated inversely to OGIS. None of the metabolic parameters were altered significantly after candesartan or telmisartan treatment in either the patient or standard care group.
  
  
  CONCLUSIONS
  Insulin sensitivity and insulin secretion are impaired in CHF and biomarkers of heart failure and atherosclerotic disease correlate to glucose metabolism.
authors.affiliation: Department of Endocrinology and Metabolism, Medical University of Vienna, Vienna, Austria.
authors.forename: M
authors.initials: M
authors.lastname: Clodi
authors.forename: M
authors.initials: M
authors.lastname: Resl
authors.forename: D
authors.initials: D
authors.lastname: Stelzeneder
authors.forename: G
authors.initials: G
authors.lastname: Pacini
authors.forename: A
authors.initials: A
authors.lastname: Tura
authors.forename: D
authors.initials: D
authors.lastname: Mörtl
authors.forename: J
authors.initials: J
authors.lastname: Struck
authors.forename: N G
authors.initials: NG
authors.lastname: Morgenthaler
authors.forename: A
authors.initials: A
authors.lastname: Bergmann
authors.forename: M
authors.initials: M
authors.lastname: Riedl
authors.forename: M
authors.initials: M
authors.lastname: Anderwald-Stadler
authors.forename: A
authors.initials: A
authors.lastname: Luger
authors.forename: R
authors.initials: R
authors.lastname: Pacher
authors.forename: M
authors.initials: M
authors.lastname: Hülsmann
mesh_terms: D001562:Benzimidazoles / Q000627:therapeutic use; D001565:Benzoates / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D001713:Biphenyl Compounds; D001786:Blood Glucose / Q000378:metabolism*; D001794:Blood Pressure / Q000187:drug effects; D002908:Chronic Disease; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy / Q000378:metabolism* / Q000503:physiopathology; D006801:Humans; D050356:Lipid Metabolism / Q000187:drug effects; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D000077333:Telmisartan; D013777:Tetrazoles / Q000627:therapeutic use
chemical_list: D001562:Benzimidazoles; D001565:Benzoates; D015415:Biomarkers; D001713:Biphenyl Compounds; D001786:Blood Glucose; D013777:Tetrazoles; C081643:candesartan; D000077333:Telmisartan