Randomized comparison of the effects of rosiglitazone vs. placebo on peak integrated cardiovascular performance, cardiac structure, and function
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AIMS: To assess the effect of rosiglitazone on cardiovascular performance and cardiac function. METHODS AND RESULTS: One hundred and fifty type 2 diabetes patients with cardiovascular disease (CVD) or ≥ 1 other CVD risk factor were randomized to receive rosiglitazone vs. placebo for 6 months. The primary outcome was peak oxygen uptake indexed to fat-free mass (VO(2peak)-FFM) during maximum exercise. A subset of 102 subjects underwent cardiac magnetic resonance imaging (cMRI). On hundred and eight subjects completed the study, including 75 completing the cMRI substudy. No significant differences were observed in mean VO(2peak)-FFM between rosiglitazone and placebo (26.1 ± 7.0 vs. 27.6 ± 6.6 mL/kg-FFM/min; P = 0.26). Compared with placebo, the rosiglitazone group had lower hematocrit (38 vs. 41%; P < 0.001) and more peripheral oedema (53.7 vs. 33.3%; P = 0.03). In the cMRI substudy, compared with placebo, the rosiglitazone group had larger end-diastolic volume (128.1 vs. 112.0 mL; P = 0.01) and stroke volume (83.7 vs. 72.9 mL; P = 0.01), and a trend toward increased peak ventricular filling rate (79.4 vs. 60.5; P = 0.07). CONCLUSION: Rosiglitazone increased peripheral oedema but had no pernicious effects on cardiovascular performance or cardiac function, with modest improvement in selected cMRI measures. Changes in indirect markers of plasma volume suggest expansion with rosiglitazone. TRIAL REGISTRATION: clinicaltrials.gov identifier: NCT00424762.
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Heart failure associated with thiazolidinediones appears to be attributable to expanded plasma volume, with no evidence of myocardial toxicity.
“HF associated with TZDs appears to be attributable to expanded plasma volume, with no evidence of myocardial toxicity.171”
From 2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes. (2023) · cites this paper as [171]
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- Authors
- McGuire, D. K., Abdullah, S. M., See, R., Snell, P. G., McGavock, J., Szczepaniak, L. S., Ayers, C. R., Drazner, M. H., Khera, A., & de Lemos, J. A.
- Affiliations
- The University of Texas Southwestern Medical Center (US)
- Brigham and Women's Hospital (US)
- Vanderbilt University (US)
- University of Alberta (CA)
- Corresponding author
- McGuire, D. K.
- Venue
- European Heart Journal
- Publisher
- Oxford University Press (OUP)
- Published
- 2010-07-02
- Volume
- 31
- Issue
- 18
- Pages
- 2262-2270
- ISSN
- 0195-668X (ISSN-L)
- 1522-9645
- PMC
- PMC2938467
- OpenAlex
- W1986608868
- Cited by
- 29
- References
- 36
- Citations by year
- 2023: 1 · 2021: 1 · 2019: 1 · 2018: 5 · 2016: 4 · 2015: 6 · 2014: 2 · 2013: 2 · 2012: 1
- FWCI
- 1.98
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Heart Journal (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Center for Research Resources (M01RR000633, M01 RR00633)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- rosiglitazone, type 2 diabetes, cardiovascular disease, peak oxygen uptake, exercise capacity, cardiac function, cardiac structure, end-diastolic volume, stroke volume, peripheral edema, hematocrit, plasma expansion, PPARγ agonists
- MeSH terms
- Rosiglitazone, Diabetes Mellitus, Type 2, Diabetic Angiopathies, Double-Blind Method, Exercise Test, Female, Humans, Hypoglycemic Agents, Male, Middle Aged, Oxygen Consumption, Plasma Volume, Stroke Volume, Treatment Outcome, Magnetic Resonance Angiography, Thiazolidinediones
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