Insulin resistance and exercise tolerance in heart failure patients: linkage to coronary flow reserve and peripheral vascular function
| العنوان: | Insulin resistance and exercise tolerance in heart failure patients: linkage to coronary flow reserve and peripheral vascular function |
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| المؤلفون: | Martin Snoer, Tea Monk-Hansen, Hanne Rasmusen, Eva Prescott, Lene Rørholm Pedersen, Rasmus Huan Olsen, Flemming Dela, Lene Simonsen |
| المصدر: | Cardiovascular Diabetology, Vol 11, Iss 1, p 97 (2012) Cardiovascular Diabetology |
| بيانات النشر: | BMC, 2012. |
| سنة النشر: | 2012 |
| مصطلحات موضوعية: | Blood Glucose, Male, lcsh:Diseases of the circulatory (Cardiovascular) system, Coronary flow reserve, medicine.medical_treatment, Denmark, Endocrinology, Diabetes and Metabolism, Fractional flow reserve, Ventricular Function, Left, Absorptiometry, Photon, Risk Factors, Insulin, Original Investigation, Ultrasonography, Exercise Tolerance, Glucose clamp technique, Middle Aged, Insulin sensitivity, Arterial stiffness, Exercise Therapy, Fractional Flow Reserve, Myocardial, Cardiology, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Heart failure, Exercise intolerance, Pulse Wave Analysis, Risk Assessment, Insulin resistance, Vascular Stiffness, Predictive Value of Tests, Internal medicine, medicine, Exercise capacity, Humans, Aged, Chi-Square Distribution, business.industry, Stroke Volume, medicine.disease, lcsh:RC666-701, Multivariate Analysis, Exercise Test, Glucose Clamp Technique, Linear Models, Endothelium, Vascular, Insulin Resistance, business, Biomarkers |
| الوصف: | Background Insulin resistance has been linked to exercise intolerance in heart failure patients. The aim of this study was to assess the potential role of coronary flow reserve (CFR), endothelial function and arterial stiffness in explaining this linkage. Methods 39 patients with LVEF 2peak), digital measurement of endothelial function and arterial stiffness (augmentation index), dual X-ray absorptiometry scan (DEXA) for body composition and insulin sensitivity by a 2 hr hyperinsulinemic (40 mU/min/m2) isoglycemic clamp. Results Fat free mass adjusted insulin sensitivity was significantly correlated to VO2peak (r = 0.43, p = 0.007). Median CFR was 1.77 (IQ 1.26-2.42) and was correlated to insulin sensitivity (r 0.43, p = 0.008). CFR (r = 0.48, p = 0.002), and arterial stiffness (r = −0.35, p = 0.04) were correlated to VO2peak whereas endothelial function and LVEF were not (all p > 0.15). In multivariable linear regression adjusting for age, CFR remained independently associated with VO2peak (standardized coefficient (SC) 1.98, p = 0.05) whereas insulin sensitivity (SC 1.75, p = 0.09) and arterial stiffness (SC −1.17, p = 0.29) were no longer associated with VO2peak. Conclusions The study confirms that insulin resistance is associated with exercise intolerance in heart failure patients and suggests that this is partly through reduced CFR. This is the first study to our knowledge that shows an association between CFR and exercise capacity in heart failure patients and links the relationship between insulin resistance and exercise capacity to CFR. |
| اللغة: | English |
| تدمد: | 1475-2840 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::12bdc5c98832b9fb368d57906440aa4aTest http://www.cardiab.com/content/11/1/97Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....12bdc5c98832b9fb368d57906440aa4a |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14752840 |
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