Document Detail


The effect of metformin on insulin resistance and exercise parameters in patients with heart failure.
MedLine Citation:
PMID:  22740509     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: Chronic heart failure (CHF) is an insulin-resistant state. The degree of insulin resistance (IR) correlates with disease severity and is associated with reduced exercise capacity. In this proof of concept study, we have examined the effect of metformin on IR and exercise capacity in non-diabetic CHF patients identified to have IR.
METHODS AND RESULTS: In a double-blind, placebo-controlled study, 62 non-diabetic IR CHF patients (mean age, 65.2 ± 8.0 years; male, 90%; left ventricular ejection fraction, 32.6 ± 8.3%; New York Heart Association class I/II/III/IV, 11/45/6/0) were randomized to receive either 4 months of metformin (n = 39, 2 g/day) or matching placebo (n = 23). IR was defined by a fasting insulin resistance index (FIRI) ≥2.7. Cardiopulmonary exercise testing and FIRI were assessed at baseline and after 4 months of intervention. Compared with placebo, metformin decreased FIRI (from 5.8 ± 3.8 to 4.0 ± 2.5, P < 0.001) and resulted in a weight loss of 1.9 kg (P < 0.001). The primary endpoint of the study, peak oxygen uptake (VO(2)), did not differ between treatment groups. However, metformin improved the secondary endpoint of the slope of the ratio of minute ventilation to carbon dioxide production (VE/VCO(2) slope), from 32.9 ± 15.9 to 28.1 ± 8.8 (P = 0.034). In the metformin-treated group, FIRI was significantly related to the reduction of the VE/VCO(2) slope (R = 0.41, P = 0.036).
CONCLUSION: Metformin treatment significantly improved IR but had no effect on peak VO(2), the primary endpoint of our study. However, metformin treatment did result in a significant improvement in VE/VCO(2) slope.
TRIAL REGISTRATION: NCT00473876.
Authors:
Aaron K F Wong; Ruth Symon; Matlooba A AlZadjali; Donald S C Ang; Simon Ogston; AnnaMaria Choy; John R Petrie; Allan D Struthers; Chim C Lang
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Review     Date:  2012-06-27
Journal Detail:
Title:  European journal of heart failure     Volume:  14     ISSN:  1879-0844     ISO Abbreviation:  Eur. J. Heart Fail.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-22     Completed Date:  2013-04-01     Revised Date:  2014-07-31    
Medline Journal Info:
Nlm Unique ID:  100887595     Medline TA:  Eur J Heart Fail     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1303-10     Citation Subset:  IM    
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00473876
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MeSH Terms
Descriptor/Qualifier:
Aged
Diabetes Mellitus / pathology
Double-Blind Method
Exercise*
Exercise Test
Exercise Tolerance / drug effects*,  physiology
Female
Humans
Hypoglycemic Agents / pharmacology,  therapeutic use*
Insulin Resistance*
Male
Metformin / pharmacology,  therapeutic use*
Middle Aged
Oxygen Consumption
Statistics as Topic
Stroke Volume
Ventricular Function, Left
Grant Support
ID/Acronym/Agency:
PG/06/143/21897//British Heart Foundation
Chemical
Reg. No./Substance:
0/Hypoglycemic Agents; 9100L32L2N/Metformin
Comments/Corrections
Comment In:
Eur J Heart Fail. 2012 Nov;14(11):1197-8   [PMID:  23054099 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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