Abstract
AIM: Chronic heart failure is associated with endothelial dysfunction and insulin resistance. The aim of this investigation was to study insulin-stimulated endothelial function and glucose uptake in skeletal muscles in patients with heart failure in comparison to patients with type 2 diabetes.
METHODS: Twenty-three patients with systolic heart failure and no history of diabetes, seven patients with both systolic heart failure and type 2 diabetes, 19 patients with type 2 diabetes, and ten healthy controls were included in the study. Endothelial function was studied by venous occlusion plethysmography. Insulin-stimulated endothelial function was assessed after intra-arterial infusion of insulin followed by co-infusion with serotonin in three different dosages. Forearm glucose uptake was measured during the insulin infusion.
RESULTS: Patients with systolic heart failure had impaired insulin-stimulated endothelial function. The percentage increase in blood flow during co-infusion with insulin and serotonin dose response study was 24.74% ± 6.16%, 23.50% ± 8.32%, and 22.29% ± 10.77% at the three doses respectively, compared to the healthy control group 45.96% ± 11.56%, 67.40% ± 18.11% and 84.57% ± 25.73% (P = 0.01). Insulin-stimulated endothelial function was similar in heart failure patients and patients with type 2 diabetes, while it was further deteriorated in patients suffering from both heart failure and diabetes with a percentage increase in blood flow of 19.15% ± 7.81%, -2.35% ± 11.76%, and 5.82% ± 17.70% at the three doses of serotonin, respectively. Forearm glucose uptake was impaired in patients with heart failure compared to healthy controls (P = 0.03) and tended to be further impaired by co-existence of diabetes (P = 0.08).
CONCLUSION: Systolic heart failure and type 2 diabetes result in similar vascular insulin resistance and reduced muscular insulin-stimulated glucose uptake. The effects of systolic heart failure and type 2 diabetes appear to be additive.
| Original language | English |
|---|---|
| Journal | Vascular Health and Risk Management (Online) |
| Volume | 7 |
| Pages (from-to) | 771-6 |
| Number of pages | 6 |
| ISSN | 1178-2048 |
| DOIs | |
| Publication status | Published - 2011 |
Keywords
- Aged
- Diabetes Mellitus, Type 2
- Endothelium, Vascular
- Female
- Forearm
- Glucose
- Heart Failure
- Humans
- Hypoglycemic Agents
- Infusions, Intra-Arterial
- Insulin
- Insulin Resistance
- Male
- Middle Aged
- Muscle, Skeletal
- Plethysmography
- Regional Blood Flow
- Serotonin
- Serotonin Receptor Agonists
- Vasodilation
