title: Insulin sensitization therapy and the heart: focus on metformin and thiazolidinediones.
abstract: Chronic heart failure (CHF) is an insulin-resistant (IR) state and the degree of IR is related to disease severity and poor clinical outcome in CHF. IR may be pathophysiologically linked with CHF. Therefore, IR may represent a new target for treatment in CHF. Metformin and thiazolidinediones (TZDs) are effective diabetic therapies that are insulin sensitizers. TZDs are contraindicated in CHF because their use is associated with increased incidence of CHF as a result of their effects on renal sodium reabsorption and vascular permeability. There is evidence to suggest that metformin may be both safe and useful in CHF.
authors.affiliation: Division of Cardiovascular and Diabetes Medicine, Medical Research Institute, Ninewells Hospital and Medical School, University of Dundee, Dundee, United Kingdom.
authors.forename: Aaron K F
authors.initials: AK
authors.lastname: Wong
authors.forename: Allan D
authors.initials: AD
authors.lastname: Struthers
authors.forename: Anna Maria J
authors.initials: AM
authors.lastname: Choy
authors.forename: Chim C
authors.initials: CC
authors.lastname: Lang
mesh_terms: D000818:Animals; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004195:Disease Models, Animal; D018450:Disease Progression; D006321:Heart / Q000187:drug effects; D006333:Heart Failure / Q000378:metabolism / Q000473:pathology / Q000517:prevention & control*; D006801:Humans; D007004:Hypoglycemic Agents / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D007328:Insulin / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D007333:Insulin Resistance; D008687:Metformin / Q000627:therapeutic use*; D012720:Severity of Illness Index; D045162:Thiazolidinediones / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin; D045162:Thiazolidinediones; D008687:Metformin