title: Allopurinol reduces left ventricular mass in patients with type 2 diabetes and left ventricular hypertrophy.
abstract: OBJECTIVE
  This study sought to ascertain whether high-dose allopurinol causes regression of left ventricular mass (LVM) in patients with type 2 diabetes mellitus (T2DM).
  
  
  BACKGROUND
  Left ventricular hypertrophy (LVH) is common in T2DM and contributes to patients' high cardiovascular (CV) event rate. Oxidative stress (OS) has been implicated in LVH development, and allopurinol has been previously shown to reduce vascular OS. We therefore investigated whether allopurinol causes regression of LVH in patients with T2DM.
  
  
  METHODS
  We conducted a randomized, double-blind, placebo-controlled study of 66 optimally-treated T2DM patients with echocardiographic evidence of LVH. Allopurinol, 600 mg/day, or placebo was given over the study period of 9 months. The primary outcome was reduction in LVM as calculated by cardiac magnetic resonance imaging at baseline and at 9 months' follow-up. Secondary endpoints were change in flow-mediated dilation and augmentation index.
  
  
  RESULTS
  Allopurinol significantly reduced absolute LVM (-2.65 ± 5.91 g vs. placebo group +1.21 ± 5.10 g [p = 0.012]) and LVM indexed to body surface area (-1.32 ± 2.84 g/m(2) vs. placebo group +0.65 ± 3.07 g/m(2) [p = 0.017]). No significant changes were seen in either flow-mediated dilation or augmentation index.
  
  
  CONCLUSIONS
  Allopurinol causes regression of LVM in patients with T2DM and LVH. Regression of LVH has been shown previously to improve CV mortality and morbidity. Therefore, allopurinol therapy may become useful to reduce CV events in T2DM patients with LVH. (Allopurinol in Patients with Diabetes and LVH; UKCRN 8766).
authors.affiliation: Division of Cardiovascular and Diabetes Medicine, Medical Research Institute, University of Dundee, Ninewells Hospital and Medical School, Dundee, United Kingdom.
authors.forename: Benjamin R
authors.initials: BR
authors.lastname: Szwejkowski
authors.affiliation: Department of Clinical Radiology, Ninewells Hospital and Medical School, Dundee, United Kingdom.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Gandy
authors.affiliation: Division of Cardiovascular and Diabetes Medicine, Medical Research Institute, University of Dundee, Ninewells Hospital and Medical School, Dundee, United Kingdom.
authors.forename: Sushma
authors.initials: S
authors.lastname: Rekhraj
authors.affiliation: Division of Cardiovascular and Diabetes Medicine, Medical Research Institute, University of Dundee, Ninewells Hospital and Medical School, Dundee, United Kingdom; Department of Clinical Radiology, Ninewells Hospital and Medical School, Dundee, United Kingdom.
authors.forename: John G
authors.initials: JG
authors.lastname: Houston
authors.affiliation: Division of Cardiovascular and Diabetes Medicine, Medical Research Institute, University of Dundee, Ninewells Hospital and Medical School, Dundee, United Kingdom.
authors.forename: Chim C
authors.initials: CC
authors.lastname: Lang
authors.affiliation: Division of Cardiovascular and Diabetes Medicine, Medical Research Institute, University of Dundee, Ninewells Hospital and Medical School, Dundee, United Kingdom.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Morris
authors.affiliation: Division of Cardiovascular and Diabetes Medicine, Medical Research Institute, University of Dundee, Ninewells Hospital and Medical School, Dundee, United Kingdom. Electronic address: j.george@dundee.ac.uk.
authors.forename: Jacob
authors.initials: J
authors.lastname: George
authors.affiliation: Division of Cardiovascular and Diabetes Medicine, Medical Research Institute, University of Dundee, Ninewells Hospital and Medical School, Dundee, United Kingdom.
authors.forename: Allan D
authors.initials: AD
authors.lastname: Struthers
mesh_terms: D000368:Aged; D000493:Allopurinol / Q000008:administration & dosage*; D000704:Analysis of Variance; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D004311:Double-Blind Method; D005260:Female; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000150:complications / Q000188:drug therapy*; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D014527:Uric Acid / Q000097:blood
chemical_list: D014527:Uric Acid; D000493:Allopurinol
keywords: AIx; BP; CMR; CV; FMD; LV; LVH; LVMI; MRI; T2DM; allopurinol; augmentation index; blood pressure; cardiac magnetic resonance; cardiovascular; endothelial function; flow-mediated dilation; left ventricular; left ventricular hypertrophy; left ventricular mass index; magnetic resonance imaging; type 2 diabetes; type 2 diabetes mellitus