title: A randomized placebo controlled double blind crossover study of pioglitazone on left ventricular diastolic function in type 2 diabetes.
abstract: OBJECTIVE
  Thiazolidinediones (TZDs), such as pioglitazone, are widely used to treat type 2 diabetes but there is evidence that their use is associated with an increased risk of heart failure. We compared the effect of pioglitazone vs. placebo on left ventricular (LV) diastolic and systolic function in people with type 2 diabetes.
  
  
  RESULTS
  24 male or female patients with type 2 diabetes were randomized to pioglitazone (45 mg/day) or placebo in addition to current therapy for 12 weeks using a prospective double blind crossover protocol following a run-in period >1 week and a 2 week washout period at crossover. Tissue Doppler early peak velocity (e'), a measure of LV diastolic function, was the primary outcome. Pioglitazone significantly increased e' by 0.7(0.1, 1.3) cm/s (mean (95% confidence interval); p=0.02) compared with placebo. Pioglitazone also increased E/A and mitral deceleration index, ejection fraction, stroke volume and weight, whereas fasting glucose, HbA1c, total peripheral resistance and LV meridional end systolic stress were decreased.
  
  
  CONCLUSIONS
  Treatment with pioglitazone for 12 weeks improves left ventricular diastolic and systolic function in people with type 2 diabetes.
authors.affiliation: International Centre for Circulatory Health, NHLI Division, Faculty of Medicine, Imperial College London & Imperial College Healthcare NHS Trust, London, UK. a.hughes@imperial.ac.uk
authors.forename: Alun David
authors.initials: AD
authors.lastname: Hughes
authors.forename: Chloe
authors.initials: C
authors.lastname: Park
authors.forename: Katherine
authors.initials: K
authors.lastname: March
authors.forename: Emma
authors.initials: E
authors.lastname: Coady
authors.forename: Ashraf
authors.initials: A
authors.lastname: Khir
authors.forename: Nish
authors.initials: N
authors.lastname: Chaturvedi
authors.forename: Simon Alistair McGillivray
authors.initials: SA
authors.lastname: Thom
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D000077205:Pioglitazone; D011446:Prospective Studies; D045162:Thiazolidinediones / Q000494:pharmacology / Q000627:therapeutic use*; D016277:Ventricular Function, Left / Q000187:drug effects* / Q000502:physiology
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D045162:Thiazolidinediones; D000077205:Pioglitazone