Insulin resistance and inflammatory activation in older patients with systolic and diastolic heart failure. Issue 1 (16th December 2004)

• Record Type: Journal Article
• Authors: Wisniacki, N; Taylor, W; Lye, M; Wilding, J P H
• Is Part Of: Heart. Volume 91:Issue 1(2005)
• Page Start: 32
• Page End: 37
• Publication Date: 2004-12-16
• Subjects: ACE, angiotensin converting enzyme -- BMI, body mass index -- CHF, chronic heart failure -- CRP, C reactive protein -- DHF, diastolic heart failure -- ELISA, enzyme linked immunosorbent assay -- HOMA, homeostasis model assessment -- IL-6, interleukin 6 -- IR, insulin resistance -- LV, left ventricular -- NYHA, New York Heart Association -- SC, standardised coefficient -- SHF, systolic heart failure -- TNF-αSRII, tumour necrosis factor α soluble receptor II; heart failure -- diastole -- cytokines -- insulin; Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/hrt.2003.029652
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Objective: To evaluate insulin resistance and systemic inflammation in older patients with systolic (SHF) or diastolic heart failure (DHF). Patients: 52 non-diabetic patients (> 70 and < 90 years old) with chronic heart failure (CHF) and hospitalised within the previous six months for heart failure were studied, together with a control group of older healthy volunteers (n = 26). On the basis of Doppler echocardiographic criteria patients were classed as having SHF (n = 27) or DHF (n = 25). Main outcome measures: Fasting glucose, insulin, C reactive protein, interleukin 6, and tumour necrosis factor α soluble receptor II (TNF-αSRII) concentrations were determined. Insulin resistance was estimated by the homeostasis model assessment (HOMA). Results: HOMA index (median, interquartile range) was higher in patients with DHF (1.77, 1.06–2.26) than in patients with SHF (0.97, 0.81–1.85) or healthy volunteers (1.04, 0.76–1.44; p = 0.01). After adjustment for body mass index, age, and use of angiotensin converting enzyme inhibitors, both groups of patients with CHF were more insulin resistant than were healthy volunteers (p = 0.02). C reactive protein, interleukin 6, and TNF-αSRII were all significantly (p < 0.001) higher in patients with DHF and SHF than in healthy volunteers. All markers of systemic inflammation were independently associated with the presence of clinical CHF. Conclusion: Insulin resistance and inflammatory activation are present in older patients with SHF and DHF.