medigraphic.com
SPANISH

Revista Mexicana de Cardiología

ISSN 0188-2198 (Print)
En 2019, la Revista Mexicana de Cardiología cambió a Cardiovascular and Metabolic Science

Ver Cardiovascular and Metabolic Science


  • Contents
  • View Archive
  • Information
    • General Information        
    • Directory
  • Publish
    • Instructions for authors        
    • Send manuscript
  • medigraphic.com
    • Home
    • Journals index            
    • Register / Login
  • Mi perfil

2016, Number 1

<< Back Next >>

Rev Mex Cardiol 2016; 27 (1)

Metformin enhances left ventricular function in patients with metabolic syndrome

Velázquez H, Meaney A, Galeana C, Zempoalteca JC, Gutiérrez-Salmeán G, Nájera N, Ceballos G, Meaney E
Full text How to cite this article

Language: English
References: 36
Page: 16-25
PDF size: 315.05 Kb.


Key words:

Metabolic syndrome, metformin, left ventricular diastolic dysfunction, tissue Doppler imaging, speckle tracking.

ABSTRACT

Background: Metabolic syndrome foretells several cardiovascular complications, including heart failure (HF). Left ventricular (LV) dysfunction accompanies the MS. Although metformin improves LV function in diabetics with HF, there is no evidence of its effect on LV dysfunction in MS patients. We studied the effect of metformin on LV dysfunction in MS patients using tissue Doppler myocardial imaging and two-dimensional speckle tracking. Aims: To evaluate the effects of metformin on metabolic syndrome (MS) induced left ventricular dysfunction. Material and methods: Patients with MS were randomly allocated into two groups (n = 20 each) receiving, an antagonist of angiotensin 2 receptors and; statins, fibrates or both. One group received 850 mg of metformin daily. LV mass, relative wall thickness (RWT), ejection fraction, E/A and E/E’ relationship, systolic tissue Doppler velocity (Sm), mean peak systolic strain (SS), and peak early diastolic strain rate (SR-LVe) echocardiographic measurements, at baseline and six months were obtained. Results: All patients had LH concentric hypertrophy or remodeling. Metformin reduced LV mass and RWT. There were LV systolic and diastolic alterations in both groups that metformin improved significantly. SR-LVe increased nearly 2-fold with metformin. Diastolic function improvement was not related to regression of hypertrophy. Conclusions: Patients with MS experienced subtle alterations of systolic and diastolic functions, which improved significantly with a small dosage of metformin over a treatment period of six months.


REFERENCES

  1. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA. 2001; 285 (19): 2486-2497.

  2. Zimmet PZ, Alberti KG, Shaw JE. Mainstreaming the metabolic syndrome: a definitive definition. This new definition should assist both researchers and clinicians. Med J Aust. 2005; 183: 175-176.

  3. Sánchez-Castillo CP, Velázquez-Monroy O, Lara-Esqueda A, Fanghänel G, Violante R, Tapia-Conyer R et al. Diabetes and hypertension increases in a society with abdominal obesity: results of the Mexican National Health Survey 2000. Pub Health Nutr. 2004; 8: 53-60.

  4. Aguilar-Salinas CA, Rojas R, Gómez-Pérez FJ, Valles V, Ríos-Torres JM, Franco A et al. High prevalence of metabolic syndrome in Mexico. Arch Med Res. 2004; 35: 76-81.

  5. Meaney E, Lara-Esqueda A, Ceballos-Reyes GM, Asbun J, Vela A, Martínez-Marroquín Y et al. Cardiovascular risk factors in the urban Mexican population: the FRIMEX study. Public Health. 2007; 121: 378-384.

  6. Lyssenko V, Jonsson A, Almgren P, Pulizzi N, Isomaa B, Tuomi T et al. Clinical risk factors, DNA variants, and the development of type 2 diabetes. N Engl J Med. 2008; 359: 2220-2223.

  7. Duncan E, Ezzat V, Kearney M. Insulin and endothelial function: physiological environment defines effect on atherosclerotic risk. Curr Diabetes Rev. 2006; 2: 51-60.

  8. Meaney E, Vela A, Samaniego V, Meaney A, Asbún J, Zempoalteca JC et al. Metformin, arterial function, intima-media, thickness and nitroxidation in metabolic syndrome: the MEFISTO study. Clin Exp Pharmacol Physiol. 2008; 35: 895-903.

  9. Després JP. Inflammation and cardiovascular disease: is abdominal obesity the missing link? Int J Obes Relat Metab Disord. 2003; 27 Suppl 3: S22-S24.

  10. Isomaa B, Almgren P, Tuomi T, Forsén B, Lahti K, Nissén M et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care. 2001; 24: 683-689.

  11. Kenchaiah S, Evans JC, Levy D, Wilson PW, Benjamin EJ, Larson MG et al. Obesity and the risk of heart failure. N Engl J Med. 2002; 347: 305-313.

  12. Lloyd-Jones D, Adams R, Carnethon M, De Simone G, Ferguson TB, Flegal K et al. Heart disease and stroke statistics--2009 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2009; 119: 480-486.

  13. Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. The SOLVD Investigators. N Engl J Med. 1991; 325: 293-302.

  14. Inzucchi SE. Metformin and heart failure. Innocent until proven guilty. Diabetes Care. 2005; 28: 2585-2587.

  15. Aguilar D, Chan W, Bozkurt B, Ramasubbu K, Deswal A. Metformin use and mortality in ambulatory patients with diabetes and heart failure. Circ Heart Fail. 2011; 4: 53-58.

  16. Kittappa P, Mitra S. Merformin beyond hypoglycemic effect. IJCCI. 2012; 4: 5-12.

  17. Nagueh SF. Tissue Doppler imaging for the assessment of left ventricular diastolic function. J Cardiovasc Ultrasound. 2008; 16: 76-79.

  18. Sitia S, Tomasoni L, Turiel M. Speckle tracking echocardiography: a new approach to myocardial function. World J Cardiol. 2010; 26: 1-5.

  19. De Simone G, Devereaux RB, Chinali M, Roman MJ, Lee ET, Resnick HE et al. Metabolic syndrome and left ventricular hypertrophy in the prediction of cardiovascular events. Nutr Metab Cardiovasc Dis. 2009; 19: 98-104.

  20. World Medical Association, Declaration of Helsinki. Adoptada por la 18 Asamblea Médica Mundial. Helsinki, Finlandia, 1964 y corregida por la 29 Asamblea (Tokio, Japón, 1975), la 35 (Venecia, Italia, 1983) y la 41 (Hong Kong, 1989). Disponible en: http://ohsr.od.nih.gov/Helsinki.php3

  21. Ley General de Salud, Reglamento de Investigación Clínica. Título 5o. Capítulo único. Diario Oficial de la Federación, 24 de diciembre de 1986. Disponible en: http://www.salud.gob.mx/unidades/cdi/nom/compi/rlgsmis.html

  22. Sánchez-Castillo CP, Velázquez-Monroy O, Berber A, Lara-Esqueda A, Tapia-Conyer R, James WP. Anthropometric cutoff points predicting chronic diseases in the National Health Survey 2000. Obes Res. 2003; 11: 442-451.

  23. Muniyappa R, Lee S, Chen H, Quon MJ. Current approaches for assessing insulin sensitivity and resistance in vivo: advantages, limitations, and appropriate usage. Am J Physiol Endocrinol Metab. 2008; 294: E15-E16.

  24. Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA et al. Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr. 2005; 18: 1440-1463.

  25. Devereux RB, Reichek N. Echocardiographic determination of left ventricular mass in man. Anatomic validation of the method. Circulation. 1977; 55: 613-618.

  26. Gerdts E. Left ventricular structure in different types of chronic pressure overload. Eur Heart J. 2008; 10 (Supplement E): E23-E30.

  27. Goffinet C, Vanoverschelde JL. Speckle tracking echocardiography. Eur Cardiol. 2007; 3: 1-3.

  28. Aijaz B, Ammar KA, Lopez-Jimenez F, Redfield MM, Jacobsen SJ, Rodeheffer RJ. Abnormal cardiac structure and function in the metabolic syndrome: a population-based study. Mayo Clin Proc. 2008; 83: 1350-1357.

  29. de las Fuentes L, Brown LA, Mathews SJ, Waggoner AD, Soto PF, Gropler RJ et al. Metabolic syndrome is associated with abnormal left ventricular diastolic function independent of left ventricular mass. Eur Heart J. 2007; 28: 553-559.

  30. Roberts AW, Clark AL, Witte KK. Left ventricular dysfunction and heart failure in metabolic syndrome and diabetes without overt coronary artery disease – do we need to screen our patients? Diab Vasc Dis Res. 2009; 6: 153-163.

  31. von Bibra H, St John-Sutton M. Diastolic dysfunction in diabetes and the metabolic syndrome: promising potential for diagnosis and prognosis. Diabetologia. 2010; 53: 1033-1045.

  32. Fischer M, Baessler A, Hense HW, Hengstenberg C, Muscholl M, Holmer S et al. Prevalence of left ventricular diastolic dysfunction in the community. Results from a Doppler echocardiographic-based survey of a population sample. Eur Heart J. 2003; 24: 320-328.

  33. Owan TE, Hodge DO, Herges RM, Jacobson SJ, Roger VL, Redfield MM. Trends in prevalence and outcome of heart failure with preserved ejection fraction. N Engl J Med. 2006; 355: 251-259.

  34. Meaney E, Sierra-Vargas P, Meaney A, Guzmán-Grenfell M, Ramírez-Sánchez I, Hicks JJ et al. Does metformin increase paraoxonase activity in patients with the metabolic syndrome? Additional data from the MEFISTO study. Clin Transl Sci. 2012; 5: 265-268.

  35. Sasaki H, Asanuma H, Fujita M, Takahama H, Wakeno M, Ito S et al. Metformin prevents progression of heart failure in dogs. Circulation. 2009; 119: 2568-2577.

  36. Yin M, van der Horst IC, van Melle JP, Qian C, van Gilst WH, Silljé HH et al. Metformin improves cardiac function in a nondiabetic rat model of post-MI heart failure. Am J Physiol Heart Circ Physiol. 2011; 301: H459-H468.




2020     |     www.medigraphic.com

Mi perfil

C?MO CITAR (Vancouver)

Rev Mex Cardiol. 2016;27