Increased insulin and glucose levels in heart failure (HF)

Suskin, Neville; McKelvie, Robert S.; Rouleau, Jean L.; Sigoun, C.; Wiecek, Elizabeth M.; Yusuf, S.

doi:10.1016/s0735-1097(98)81722-1

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Factors Leading To Development Of Heart Failure1

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2003

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“…It is seen in about 20% of patients, with a similar number of patients having glucose intolerance, indicating that about 40% of heart failure patients have glucose abnormalities 6 – 11. In asymptomatic patients with ejection fraction of ≤35%, diabetes was an independent predictor for mortality, development of heart failure, and admission to hospital for heart failure 12.…”

Section: Factors Leading To Development Of Heart Failurementioning

confidence: 98%

Evidence based cardiology: Prevention of congestive heart failure and management of asymptomatic left ventricular dysfunction

McKelvie

Benedict²,

Yusuf

1999

BMJ

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Section: Factors Leading To Development Of Heart Failurementioning

confidence: 98%

Evidence based cardiology: Prevention of congestive heart failure and management of asymptomatic left ventricular dysfunction

McKelvie

Benedict²,

Yusuf

1999

BMJ

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Heart Failure

2003

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There is a high frequency of heart failure (HF) accompanied by an increased mortality risk for patients with diabetes. The poor prognosis of these patients has been explained by an underlying diabetic cardiomyopathy exacerbated by hypertension and ischemic heart disease. In these patients, activation of the sympathetic nervous system results in increased myocardial utilization of fatty acids and induction of fetal gene programs, decreasing myocardial function. Activation of the renin-angiotensin system results in myocardial remodeling. It is imperative for physicians to intercede early to stop the progression of HF, yet at least half of patients with left ventricular dysfunction remain undiagnosed and untreated until advanced disease causes disability. This delay is largely because of the asymptomatic nature of early HF, which necessitates more aggressive assessment of HF risk factors and early clinical signs. Utilization of ␤-blockade, ACE inhibitors, or possibly angiotensin receptor blockers is essential in preventing remodeling with its associated decline in ventricular function. ␤-Blockers not only prevent, but may also reverse, cardiac remodeling. Glycemic control may also play an important role in the therapy of diabetic HF. The adverse metabolic side effects that have been associated with ␤-adrenergic inhibitors in the diabetic patient may be circumvented by use of a third-generation ␤-blocker. Prophylactic utilization of ACE inhibitors and ␤-blockers to avoid, rather than await, the need to treat HF should be considered in high-risk diabetic patients.

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Increased insulin and glucose levels in heart failure (HF)

Cited by 2 publications

References 0 publications

Evidence based cardiology: Prevention of congestive heart failure and management of asymptomatic left ventricular dysfunction

Evidence based cardiology: Prevention of congestive heart failure and management of asymptomatic left ventricular dysfunction

Heart Failure

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