Metformin is associated with improved left ventricular diastolic function measured by tissue Doppler imaging in patients with diabetes.
OBJECTIVE
To examine the association between selected glucose-lowering medications and left ventricular (LV) diastolic function in patients with diabetes.


METHODS
Retrospective cohort study (years 2005-2008).


METHODS
Echocardiograms of 242 patients with diabetes undergoing coronary angiography were analyzed. All patients had an LV ejection fraction (LVEF) ≥20% and were without atrial fibrillation, bundle branch block, valvular disease, or cardiac pacemaker. Patients were grouped according to the use of metformin (n=56), sulfonylureas (n=43), insulin (n=61), and combination treatment (n=82).


RESULTS
Mean age (66±10 years) and mean LVEF (45±11%) were similar across the groups. Mean isovolumic relaxation time (IVRT) was 66±31, 79±42, 69±23, and 66±29 ms in metformin, sulfonylureas, insulin, and combination treatment groups respectively (P=0.4). Mean early diastolic longitudinal tissue velocity (e') was 5.3±1.6, 4.6±1.6, 5.3±1.8, and 5.4±1.7 cm/s in metformin, sulfonylureas, insulin, and combination treatment groups (P=0.04). In adjusted linear regression models, the use of metformin was associated with a shorter IVRT (parameter estimate -9.9 ms, P=0.049) and higher e' (parameter estimate +0.52 cm/s, P=0.03), compared with no use of metformin. The effects of metformin were not altered by concomitant use of sulfonylureas or insulin (P for interactions >0.4).


CONCLUSIONS
The use of metformin is associated with improved LV relaxation, as compared with no use of metformin.
Andersson
Charlotte
C
Department of Cardiology, Copenhagen University Hospital, Gentofte, Copenhagen, Denmark. ca@heart.dk
Søgaard
Peter
P
Hoffmann
Søren
S
Hansen
Peter R
PR
Vaag
Allan
A
Major-Pedersen
Atheline
A
Hansen
Thomas Fritz
TF
Bech
Jan
J
Køber
Lars
L
Torp-Pedersen
Christian
C
Gislason
Gunnar H
GH
D000368:Aged; D015331:Cohort Studies; D017023:Coronary Angiography; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004452:Echocardiography; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D008297:Male; D008687:Metformin / Q000494:pharmacology* / Q000627:therapeutic use*; D008875:Middle Aged; D012189:Retrospective Studies; D016277:Ventricular Function, Left / Q000187:drug effects*
D007004:Hypoglycemic Agents; D008687:Metformin