Glucose and insulin abnormalities relate to functional capacity in patients with congestive heart failure
| Autor: | J Probstfield, R.J Burns, Michel White, Roberto Latini, D. Pericak, Neville Suskin, C.B Solymoss, Jean-Lucien Rouleau, Salim Yusuf, Ross T. Tsuyuki, Robert S. McKelvie, C Sigouin |
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| Rok vydání: | 2000 |
| Předmět: |
Cardiac function curve
Blood Glucose Male medicine.medical_specialty medicine.medical_treatment Pilot Projects New york heart association Ventricular Function Left Cohort Studies Risk Factors Diabetes mellitus Internal medicine Hyperinsulinism medicine Diabetes Mellitus Humans Insulin In patient Heart Failure Ejection fraction business.industry Incidence Stroke Volume Middle Aged medicine.disease Prognosis Myocardial Contraction Endocrinology Heart failure Hyperglycemia Cardiology Exercise Test Functional status Female Insulin Resistance Cardiology and Cardiovascular Medicine business Biomarkers |
| Zdroj: | European heart journal. 21(16) |
| ISSN: | 0195-668X |
| Popis: | In addition to diabetes mellitus, less severe abnormalities of glucose and insulin metabolism may be related to functional status in patients with heart failure. We examined the relationship of hyperglycaemia (or =6.1 mmol. l(-1)) and hyperinsulinaemia (or =11.2 mU. l(-1)) to functional status and cardiac function in patients with heart failure.Fasting plasma glucose and insulin levels were obtained in 663 heart failure patients. The average left ventricular ejection fraction was 0.28+/-0.07, 63% were in New York Heart Association Functional Class (NYHA-FC) I/II and 37% were in NYHA-FC III/IV. Twenty seven percent had diabetes mellitus, but an additional 8% had undiagnosed diabetes mellitus (glucoseor =7 mmol. l(-1)) and 9% had glucose levels between 6.1 and 7 mmol. l(-1), so that a total of 43% (287) of patients had elevated glucose levels (or =6.1 mmol. l(-1)). In general, more diabetic patients had NYHA-FC III/IV symptoms, shorter 6 min walk distances, but similar left ventricular ejection fractions compared to non-diabetic patients. The non-diabetic patients in NYHA-FC III/IV had higher glucose and insulin levels than patients in NYHA-FC I/II (6.3+/-0.2 vs 5.6+/-0.1 mmol. l(-1), P0.001 and 19.6+/-2.3 vs 10. 2+/-0.6 mU. l(-1), P0.001). Non-diabetic patients with elevated glucose levels had shorter 6 min walk distances compared to those with normal glucose levels (368.2+/-8 m vs 389.+/-4 m, P=0.02), however, left ventricular ejection fraction was similar.Glucose abnormalities are extremely common in heart failure patients (43% of patients). Diabetes mellitus and hyperglycaemia or hyperlinsulinaemia in non-diabetic patients were related to worse symptomatic status but not worsening left ventricular ejection fraction compared to patients with normal glucose and insulin levels. |
| Databáze: | OpenAIRE |
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