title: [The relationship between insulin resistance and left ventricular systolic and diastolic functions and functional capacity in patients with chronic heart failure and metabolic syndrome].
abstract: OBJECTIVE
  The relationship between chronic heart failure (CHF) and insulin resistance (IR) has long been recognized. We examined the relationship of IR with left ventricular (LV) systolic and diastolic functions and functional capacity of CHF patients with metabolic syndrome.
  
  
  METHODS
  The study included 50 nondiabetic CHF patients with metabolic syndrome (NYHA class I-III; 40 men, 10 women; mean age 60+/-10 years). Metabolic syndrome was diagnosed according to the AHA/NHLBI (American Heart Association/National Heart, Lung, Blood Institute) criteria. Insulin resistance was determined by the homeostasis model assessment (HOMA). Pulse-wave Doppler echocardiography and tissue Doppler imaging were performed to assess LV structure and functions.
  
  
  RESULTS
  Patients with LV ejection fraction <or=40% (n=25) had significantly higher NYHA functional class (p<0.001) compared to those with EF >40% (n=25). Fasting plasma insulin concentrations and HOMA-IR did not differ significantly in this respect. No significant differences were found in LV geometrical patterns, diastolic and systolic functions in patients with (HOMA >or=2.7; n=19) or without (HOMA <2.7; n=31) HOMA-IR. However, patients with HOMA-IR had a lower NYHA functional capacity (p<0.0001). HOMA-IR showed significant increases in parallel with NYHA functional class.
  
  
  CONCLUSIONS
  Our findings suggest that IR in CHF patients with metabolic syndrome is not associated with LV systolic and diastolic functions, but is strongly linked with worsening in NYHA functional capacity.
authors.affiliation: Türkiye Yüksek Ihtisas Eğitim ve Araştirma Hastanesi, Kardiyoloji Kliniği, Ankara, Turkey. ftuna02@yahoo.com
authors.forename: Funda
authors.initials: F
authors.lastname: Başyiğit
authors.forename: Ahmet
authors.initials: A
authors.lastname: Temizhan
authors.forename: Ozgül
authors.initials: O
authors.lastname: Malçok
authors.forename: Erkan
authors.initials: E
authors.lastname: Kahraman
authors.forename: Erman
authors.initials: E
authors.lastname: Cakal
authors.forename: Mehmet Timur
authors.initials: MT
authors.lastname: Selçuk
authors.forename: Sule
authors.initials: S
authors.lastname: Korkmaz
mesh_terms: D000368:Aged; D003971:Diastole / Q000502:physiology*; D015150:Echocardiography, Doppler; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006334:Heart Function Tests; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008875:Middle Aged; D013599:Systole / Q000502:physiology*; D016277:Ventricular Function, Left / Q000502:physiology*