Rosiglitazone, but not pioglitazone, improves myocardial systolic function in type 2 diabetic patients: a tissue Doppler study.
OBJECTIVE
Despite many potential benefits, thiazolidinedione (TZD) use has been associated with increased exacerbation rate of heart failure due to fluid retention. In our study, the effect of rosiglitazone and pioglitazone on myocardial function in patients with type 2 diabetes mellitus (DM) and normal left ventricular systolic function was evaluated by both conventional echocardiography and tissue Doppler imaging (TDI).


METHODS
Forty patients who were diagnosed type 2 DM according to the American Diabetes Association criteria were included in the study. After baseline evaluation, all patients were randomly assigned to receive either rosiglitazone 4 mg twice daily or pioglitazone 30 mg daily for 4 months. Blood samples were taken and detailed pulsed-wave and tissue Doppler echocardiographic examination was performed at baseline and 4 months after TZD therapy.


RESULTS
Left ventricular systolic velocity (Sm) values were found to be significantly increased in the rosiglitazone group (+2.6 + or - 0.7 cm/sec, P < 0.0001), while they remained unchanged in the pioglitazone group. Left ventricular early diastolic velocity (Em) increased at the same extent in both groups after treatment (rosioglitazone: +0.7 + or - 0.7 cm/sec; pioglitazone: +0.5 + or - 0.4 cm/sec, P < 0.05).


CONCLUSIONS
In conclusion, while rosiglitazone and pioglitazone therapy improved metabolic parameters, blood pressure values and diastolic function similarly, in type 2 diabetic patients, only rosiglitazone improved systolic myocardial function significantly. (Echocardiography 2010;27:512-518).
Pala
Selcuk
S
Kartal Koşuyolu Yüksek Ihtisas Education and Research Hospital, Istanbul, Turkey.
Esen
Ozlem
O
Akçakoyun
Mustafa
M
Kahveci
Gökhan
G
Kargin
Ramazan
R
Tigen
Kürşat
K
Karaahmet
Tansu
T
Açar
Göksel
G
Esen
Ali Metin
AM
Kirma
Cevat
C
D001794:Blood Pressure / Q000187:drug effects*; D002319:Cardiovascular System / Q000000981:diagnostic imaging* / Q000187:drug effects*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D015150:Echocardiography, Doppler; D005260:Female; D006333:Heart Failure / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D000077205:Pioglitazone; D000077154:Rosiglitazone; D013599:Systole; D045162:Thiazolidinediones / Q000009:adverse effects / Q000627:therapeutic use*
D007004:Hypoglycemic Agents; D045162:Thiazolidinediones; D000077154:Rosiglitazone; D000077205:Pioglitazone