title: Effect of pioglitazone on arterial baroreflex sensitivity and sympathetic nerve activity in patients with acute myocardial infarction and type 2 diabetes mellitus.
abstract: Pioglitazone has been shown to reduce the occurrence of fatal and nonfatal myocardial infarction (MI) in type 2 diabetes mellitus (DM). However, the mechanisms of such favorable effects remain speculative. The aim of this study was to investigate the effect of pioglitazone on arterial baroreflex sensitivity (BRS) and muscle sympathetic nerve activity (MSNA) in 30 DM patients with recent MI. Patients were randomly assigned to those taking pioglitazone (n = 15) and those not taking pioglitazone (n = 15) at 4 weeks after the onset of MI. BRS, MSNA, calculated homeostasis model assessment of insulin resistance index (HOMA-IR), and plasma adiponectin were measured at baseline and after 12 weeks. Pioglitazone increased plasma adiponectin (from 6.9 ± 3.3 μg/dL to 12.2 ± 7.1 μg/dL) and reduced HOMA-IR (from 4.0 ± 2.2 to 2.1 ± 0.9). In the pioglitazone group, MSNA decreased significantly (from 37 ± 7 bursts/min to 25 ± 8 bursts/min) and BRS increased significantly (from 6.7 ± 3.0 to 9.9 ± 3.2 ms/mm Hg) after 12 weeks. Furthermore, a significant relationship was found between the change in MSNA and HOMA-IR (r = 0.6, P = 0.042). Thus, pioglitazone decreased the sympathetic nerve traffic through the improvement of insulin resistance in DM patients with recent MI, which indicate that the sympathoinhibitory effects of pioglitazone may, at least in part, have contributed to the beneficial effects of pioglitazone.
authors.affiliation: The Second Department of Internal Medicine, Kansai Medical University, Osaka, Japan. yokoe8@gmail.com
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yokoe
authors.forename: Fumio
authors.initials: F
authors.lastname: Yuasa
authors.forename: Reisuke
authors.initials: R
authors.lastname: Yuyama
authors.forename: Kousuke
authors.initials: K
authors.lastname: Murakawa
authors.forename: Yoko
authors.initials: Y
authors.lastname: Miyasaka
authors.forename: Susumu
authors.initials: S
authors.lastname: Yoshida
authors.forename: Satoshi
authors.initials: S
authors.lastname: Tsujimoto
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Sugiura
authors.forename: Toshiji
authors.initials: T
authors.lastname: Iwasaka
mesh_terms: D052242:Adiponectin / Q000097:blood; D000368:Aged; D017704:Baroreflex / Q000187:drug effects; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology*; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000503:physiopathology; D000077205:Pioglitazone; D013564:Sympathetic Nervous System / Q000187:drug effects; D045162:Thiazolidinediones / Q000494:pharmacology*
chemical_list: D052242:Adiponectin; D007004:Hypoglycemic Agents; D045162:Thiazolidinediones; D000077205:Pioglitazone