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Pioglitazone Improves Left Ventricular Diastolic Function

FRIDAY, Sept. 29, 2017 -- Pioglitazone improves whole-body and myocardial insulin sensitivity, left ventricular (LV) diastolic function, and systolic function in patients with type 2 diabetes, according to a small study published online Sept. 22 in Diabetes Care.

Geoffrey D. Clarke, Ph.D., from the University of Texas Health Science Center in San Antonio, and colleagues used a euglycemic insulin clamp in 12 subjects with type 2 diabetes and 12 with normal glucose tolerance. They measured myocardial glucose uptake and myocardial perfusion before and after 24 weeks of treatment with pioglitazone.

The researchers found that pioglitazone reduced HbA1c by 0.9 percent; decreased systolic and diastolic blood pressure by 7 mmHg each (P < 0.05); and increased whole-body insulin-stimulated glucose uptake by 71 percent (P < 0.01) in subjects with type 2 diabetes. Pioglitazone enhanced myocardial glucose uptake by 75 percent (P < 0.01) and myocardial perfusion by 16 percent (P < 0.05). There were also increases in measures of diastolic function, early diastolic relation/atrial contraction flow ratio, and peak LV filling rate (P < 0.01). There were nonsignificant increases in end-systolic volume, end-diastolic volume, peak LV ejection rate, and cardiac output and significant increases in ejection fraction and stroke volume (P < 0.05).

"Improved myocardial insulin sensitivity and diastolic function are strongly correlated," conclude the authors.

Several authors disclosed financial ties to pharmaceutical companies, including Takeda Pharmaceuticals, which partially funded the study.

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Posted: September 2017