title: Assessment of cardiac structure and function in patients without and with peripheral oedema during rosiglitazone treatment.
abstract: BACKGROUND
  Thiazolidinediones cause peripheral oedema, the aetiology of which remains poorly understood.
  
  
  METHODS
  In a sub-study of a 6-month trial comparing rosiglitazone (Rsg) versus placebo, we compared those with versus without oedema among the 74 subjects treated with Rsg with respect to peak oxygen consumption indexed to fat-free mass (VO(2peak-FFM) ), cardiac MRI and markers of plasma volume expansion.
  
  
  RESULTS
  Almost half (49%) of the Rsg-treated patients developed oedema. Baseline VO(2peak-FFM) was not different between those with versus without oedema (25.8 versus 28.2 ml/kg/min; p = 0.22) and declined 5% in the oedema group (Δ -1.3 ml/min/kg; p = 0.005) with no change in those without oedema. Stroke volume increased in both groups (Δ 8.7 and 8.8 ml; p < 0.001 for each); end-diastolic volume increased only in those with oedema (+13.1 ml; p = 0.001). No other cardiac function changes were observed. In both groups, weight increased (3.6 and 2.2 kg) and haematocrit decreased (-3.2% and -2.1%; p < 0.001 for each). In those with oedema, albumin decreased (-0.2 g/dl) and brain natriuretic peptide increased (11.9 pg/ml; p < 0.03 for each).
  
  
  CONCLUSIONS
  Oedema was associated with a small decline in VO(2peak FFM), no adverse effects on cardiac function, and changes in selected measures suggesting that volume expansion underpins Rsg oedema.
authors.affiliation: Department of Internal Medicine, University of Texas Southwestern Medical Center at Dallas, TX 75235-9047, USA.
authors.forename: Nikhil
authors.initials: N
authors.lastname: Narang
authors.forename: Sumiko I
authors.initials: SI
authors.lastname: Armstead
authors.forename: Amanda
authors.initials: A
authors.lastname: Stream
authors.forename: Shuaib M
authors.initials: SM
authors.lastname: Abdullah
authors.forename: Raphael
authors.initials: R
authors.lastname: See
authors.forename: Peter G
authors.initials: PG
authors.lastname: Snell
authors.forename: Jonathan
authors.initials: J
authors.lastname: McGavock
authors.forename: Colby R
authors.initials: CR
authors.lastname: Ayers
authors.forename: M Odette
authors.initials: MO
authors.lastname: Gore
authors.forename: Amit
authors.initials: A
authors.lastname: Khera
authors.forename: James A
authors.initials: JA
authors.lastname: de Lemos
authors.forename: Darren K
authors.initials: DK
authors.lastname: McGuire
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004487:Edema / Q000097:blood / Q000139:chemically induced* / Q000503:physiopathology; D005080:Exercise Test; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000139:chemically induced* / Q000473:pathology / Q000503:physiopathology; D006400:Hematocrit; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010101:Oxygen Consumption / Q000187:drug effects; D010953:Plasma Volume / Q000187:drug effects; D011446:Prospective Studies; D000077154:Rosiglitazone; D012709:Serum Albumin / Q000378:metabolism; D016037:Single-Blind Method; D013318:Stroke Volume / Q000187:drug effects; D013781:Texas; D045162:Thiazolidinediones / Q000009:adverse effects*; D013997:Time Factors; D016276:Ventricular Function / Q000187:drug effects*; D015430:Weight Gain / Q000187:drug effects
chemical_list: D015415:Biomarkers; D007004:Hypoglycemic Agents; D012709:Serum Albumin; D045162:Thiazolidinediones; D000077154:Rosiglitazone; D020097:Natriuretic Peptide, Brain