Metabolic Effects of Metformin in the Failing Heart.

Accumulating evidence shows that metformin is an insulin-sensitizing antidiabetic drug widely used in the treatment of type 2 diabetes mellitus (T2DM), which can exert favorable effects on cardiovascular risk and may be safely used in patients with heart failure (HF), and even able to reduce the incidence of HF and to reduce HF mortality. In failing hearts, metformin improves myocardial energy metabolic status through the activation of AMP (adenosine monophosphate)-activated protein kinase (AMPK) and the regulation of lipid and glucose metabolism. By increasing nitric oxide (NO) bioavailability, limiting interstitial fibrosis, reducing the deposition of advanced glycation end-products (AGEs), and inhibiting myocardial cell apoptosis metformin reduces cardiac remodeling and hypertrophy, and thereby preserves left ventricular systolic and diastolic functions.

The pathophysiological basis of the protective effects of metformin in heart failure.

Metformin, currently recommended as the drug of first choice in type 2 diabetes mellitus (T2DM), is one of the few antihiperglycemic drugs to reduce cardiovascular risk. Nonetheless, due to the risk of lactic acidosis during metformin therapy, its usage in patients with diabetes and heart failure (HF) is still a matter of debate. The aim of this review is to present data supporting the possibility of using metformin in the treatment of diabetic patients with concomitant heart failure.

The effect of caffeine ingestion on human neutrophil oxidative burst responses following time-trial cycling.

Following fixed-duration exercise of submaximal intensity, caffeine ingestion is associated with an attenuation of the exercise-induced decline in N-formyl-methionyl-phenyl-alanine (f-MLP) stimulated neutrophil oxidative burst. However, the response following high-intensity exhaustive exercise is unknown. Nine endurance-trained male cyclists ingested 6 mg caffeine or placebo per kilogram of body mass 60 min before cycling for 90 min at 70% of maximal oxygen consumption (VO2max) and then performing a time-trial requiring an energy expenditure equivalent to 30 min cycling at 70% maximum power output.