Clinical Investigation

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Evaluation of Rosiglitazone Administration on Cardiovascular Function in Severe Obesity

  1. Amelia Brunani MD1,*,
  2. Antonio Liuzzi MD1,
  3. AnnaMaria Titon MD2,
  4. Salvatore Graci MD1,
  5. Giovanna Castagna PhD3,
  6. Gian Carlo Viberti MD4,
  7. Luca A. Gondoni MD2

Article first published online: 18 DEC 2008

DOI: 10.1002/clc.20339

Issue

Clinical Cardiology

Clinical Cardiology

Volume 31, Issue 12, pages 602–606, December 2008

Additional Information

How to Cite

Brunani, A., Liuzzi, A., Titon, A., Graci, S., Castagna, G., Viberti, G. C. and Gondoni, L. A. (2008), Evaluation of Rosiglitazone Administration on Cardiovascular Function in Severe Obesity. Clinical Cardiology, 31: 602–606. doi: 10.1002/clc.20339

Author Information

  1. 1

    Department of Internal Medicine

  2. 2

    Unit of Cardiac Rehabilitation

  3. 3

    Laboratory Ospedale San Giuseppe, IRCCS, Istituto Auxologico Italiano, Verbania, Italy

  4. 4

    Department of Diabetes and Endocrinology, GKT School of Medicine, Guy's Hospital, King's College of London, London, United Kingdom

*Ospedale San Giuseppe Piancavallo 28900 Verbania, Italy

Publication History

  1. Issue published online: 18 DEC 2008
  2. Article first published online: 18 DEC 2008
  3. Manuscript Accepted: 2 NOV 2007
  4. Manuscript Received: 19 SEP 2007

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Keywords:

  • obesity;
  • left ventricular function;
  • rosiglitazone;
  • tissue Doppler imaging

Abstract

Background

Obese patients have myocardial structural and functional alterations related to insulin resistance.

Hypothesis

The purpose of the study was to analyze the effects of rosiglitazone, an insulin sensitizer agent, on cardiac morphometry and functioning.

Methods

In 2 groups of sex- and age-matched, nondiabetic, obese patients (5 men and 7 women, age 19–51 y; group A: body mass index [BMI] 40.6 ± 3.4 kg/m2; group B: BMI 42.6 ± 2.7 kg/m2), we evaluated the basal insulin sensitivity index (HOMA[IS]), body composition by bioelectrical impedance analysis and 24-h blood pressure monitoring. Furthermore, all patients underwent conventional 2-Dimensional and color Doppler echocardiography, and pulsed-wave tissue Doppler imaging (TDI). After the baseline evaluation, all patients were put on a hypocaloric diet (70% basal metabolic rate) plus placebo if they were in group A, or plus rosiglitazone (4 mg twice daily; Avandia [GlaxoSmithKline plc., Brentford, Middlesex, United Kingdom]) if they were in group B, for 6 mo.

Results

Significant decreases in body weight, total fat mass, BMI, and systolic blood pressure were registered in both groups. Rosiglitazone administration appeared more efficient in improving HOMA(IS) (mean difference: 0.30 ± 0.19 versus 0.11 ± 0.21, p < 0.05). Left ventricular (LV) diastolic diameter (49.4 ± 7.7 versus 52.3 ± 5.4 mm, p < 0.05) and E wave (0.89 ± 0.18 versus 0.99 ± 0.20 m/sec, p < 0.05) increased in the rosiglitazone group due to a rise in preload and water content without peripheral edema. The increase in systolic (Sa) wave velocity in both groups was probably a result of the general improvement in insulin metabolism and the decrease in blood pressure.

Conclusions

We confirmed the positive effect of rosiglitazone on glucose metabolism in obese, nondiabetic patients, but changes in insulin sensitivity did not explain the cardiac effects produced by further mechanisms. Copyright © 2008 Wiley Periodicals, Inc.

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