Ventricular remodeling does not accompany the development of heart failure in diabetic patients after myocardial infarction

Solomon, S.D.; Sutton, M. St. John; Lamas, G.A.

doi:10.1016/s1062-1458(03)00062-x

Cited by 16 publications

(21 citation statements)

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“…Post-MI, LV dilatation is the most powerful predictor of long-term survival [23]. Patients with diabetes paradoxically develop less adverse LV remodeling despite more frequent CHF post-MI [3]. In the present study, ZIR rats had evidence of adverse LV remodeling as reflected by LV dilatation, which increased with increasing MI size.…”

Section: Effect On Ventricular Remodelingsupporting

confidence: 45%

“…This increase occurs despite reduced adverse LV remodeling and is independent of MI size [3]. The greater risk of CHF may be the result of direct depression of the myocardial contractile apparatus with diabetes, and changes in cardiac structure [26].…”

Section: Effect On LV Functionmentioning

confidence: 99%

“…Patients with diabetes are at greater risk of developing post-MI CHF [1,3]. This increase occurs despite reduced adverse LV remodeling and is independent of MI size [3].…”

Section: Effect On LV Functionmentioning

confidence: 99%

“…These metabolic abnormalities can result in the inefficient use of energy by the heart, and in endothelial dysfunction. Paradoxically, patients with diabetes are more likely to develop congestive heart failure (CHF) despite being less prone to adverse LV remodeling [3]. Cardiovascular risk is also increased in patients with insulin resistance [4], suggesting that this pre-diabetic state per se is a risk factor.…”

Section: Introductionmentioning

confidence: 99%

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Vasopeptidase Inhibition Peri- and Post-MI in Zucker Insulin Resistant Rats: Effect on MI Size, Arrhythmias, Remodeling, Function and Fetal Gene Expression

Lapointe

Nguyen

Desjardins

et al. 2005

Cardiovasc Drugs Ther

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Mortality peri-myocardial infarction (MI) is increased with insulin resistance. As the vasopeptidase inhibitor (VPI) omapatrilat improves insulin sensitivity, it may be beneficial peri-MI in Zucker Insulin Resistant rats (ZIR). ZIR rats (n = 228) received omapatrilat 10 mg/kg/day, 7 days pre-MI, to 38 days post-MI, or control. Twenty-four protocol (n = 72): a subgroup of rats received the kinin receptor antagonist icatibant. Ambulatory ECG recordings, and MI size were evaluated. Thirty-eight-day protocol (n = 156): left ventricular (LV) remodeling, cardiac hemodynamics, morphology, infarct size, and RT-PCR for GLUT-4 and fetal genes were measured. Omapatrilat improved post-MI survival 24 h (62% vs 38%, P = 0.0007) which was maintained 38 days. There was a kinin-induced reduction of ventricular arrhythmias and there appeared to be a kinin-independent reduction in MI size (23.5 +/- 2.4% vs 17.0 +/- 2.2%, P = 0.053) for 24-h post-MI. Omapatrilat reduced but did not prevent LV dilatation, dysfunction, and fetal gene expression 38 days post-MI. Omapatrilat did not prevent reduced cardiac GLUT-4 expression. In ZIR rats, mortality post-MI is reduced by omapatrilat, due and a kinin-dependent reduction in ventricular arrhythmias and possibly a kinin-independent reduction in MI size. Ventricular dilatation, dysfunction, and fetal gene expression are variably attenuated but not prevented.

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Section: Effect On Ventricular Remodelingsupporting

confidence: 45%

Section: Effect On LV Functionmentioning

confidence: 99%

“…Patients with diabetes are at greater risk of developing post-MI CHF [1,3]. This increase occurs despite reduced adverse LV remodeling and is independent of MI size [3].…”

Section: Effect On LV Functionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Vasopeptidase Inhibition Peri- and Post-MI in Zucker Insulin Resistant Rats: Effect on MI Size, Arrhythmias, Remodeling, Function and Fetal Gene Expression

Lapointe

Nguyen

Desjardins

et al. 2005

Cardiovasc Drugs Ther

View full text Add to dashboard Cite

show abstract

“…Similarly, more long-term studies demonstrate that, despite a two-to threefold increase in the crude incidence of HF 3 months to 5 years following MI, LV systolic function is similar in those with and without diabetes [17,21••,22]. In addition, the adverse remodeling (as indicated by LV enlargement) that has been implicated in the development of post-MI HF [23] does not appear to be an independent predictor of the development of HF in the diabetic patient [21••,22] as studies have shown that LV enlargement is not greater [21••] and perhaps less [22] in diabetic patients than nondiabetic patients following MI. Echocardiographic analyses 6 months following acute MI have shown higher chamber stiffness (using mitral inflow velocities, tissue Doppler imaging, and color M-mode propagation velocity) [21••].…”

Section: Potential Mechanisms Leading To Increased Hf In Patients Witmentioning

confidence: 99%

Diabetes and heart failure in the post-myocardial infarction patient

Estep

Aguilar

2006

Curr Heart Fail Rep

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Diabetes mellitus, a disease which is increasing in prevalence, is a major risk factor for coronary heart disease. In patients following acute myocardial infarction, the presence of diabetes is a powerful risk factor for the development of heart failure, and this intersection of heart failure and diabetes following myocardial infarction carries substantial risk. The poor prognosis associated with heart failure in diabetic patients following myocardial infarction is likely multifactorial. Aggressive strategies for prevention and treatment of heart failure are crucial to reducing the risk associated with diabetes and heart failure following myocardial infarction. This review summarizes epidemiologic, pathophysiologic, and therapeutic data related to diabetes and heart failure in the post-myocardial infarction setting.

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Ethnic differences in atrial fibrillation among patients with heart failure in Asia

et al. 2020

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Aims We aimed to characterize ethnic differences in prevalence, clinical correlates, and outcomes of atrial fibrillation (AF) in heart failure (HF) with preserved and reduced ejection fraction (HFpEF and HFrEF) across Asia. Methods and results Among 5504 patients with HF prospectively recruited across 11 Asian regions using identical protocols in the Asian Sudden Cardiac Death in Heart Failure study (mean age 61 ± 13 years, 27% women, 83% HFrEF), 1383 (25%) had AF defined as a history of AF and/or AF/flutter on baseline electrocardiogram. Clinical correlates of AF were similar across ethnicities and included older age, prior stroke, higher NT-proBNP, and larger left atria. Diabetes was associated with lower odds of AF in HFrEF [adjusted odds ratio (AOR) 0.79, 95% CI 0.66-0.95] and HFpEF (AOR 0.58, 95% CI 0.39-0.84) regardless of ethnicity. Compared with Chinese ethnicity, Japanese/Koreans had higher odds of AF in HFrEF (AOR 1.76, 95% CI 1.40-2.21), while Indians had lower odds in HFrEF (AOR 0.18, 95% CI 0.13-0.24) and HFpEF (AOR 0.28, 95% CI 0.16-0.49) even after adjusting for clinical covariates. Interaction between ethnicity and region was observed among Indians, with Southeast Asian Indians having higher odds of AF (AOR 3.01, 95% CI 1.60-5.67) compared with South Asian Indians. AF was associated with poorer quality of life and increased risk of 1 year all-cause mortality or HF hospitalisation (adjusted hazard ratio 1.39, 95% CI 1.18-1.63) regardless of ethnicity. Conclusions Among patients with HF across Asia, clinical correlates and adverse outcomes associated with AF are similar across ethnicities; however, there are striking ethnic variations in the prevalence of AF that are not accounted for by known risk factors.

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Ventricular remodeling does not accompany the development of heart failure in diabetic patients after myocardial infarction

Cited by 16 publications

References 0 publications

Vasopeptidase Inhibition Peri- and Post-MI in Zucker Insulin Resistant Rats: Effect on MI Size, Arrhythmias, Remodeling, Function and Fetal Gene Expression

Vasopeptidase Inhibition Peri- and Post-MI in Zucker Insulin Resistant Rats: Effect on MI Size, Arrhythmias, Remodeling, Function and Fetal Gene Expression

Diabetes and heart failure in the post-myocardial infarction patient

Ethnic differences in atrial fibrillation among patients with heart failure in Asia

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