Effects of oral amino acid supplements on cardiac function and remodeling in patients with type 2 diabetes with mild-to-moderate left ventricular dysfunction.

The aim of this study was to evaluate the effects of an oral special mixture of amino acid (AA) supplements alongside angiotensin-converting enzyme (ACE) inhibitor therapy on left ventricular (LV) function and symptoms in patients with type 2 diabetes mellitus with mild-to-moderate LV dysfunction. It is established that the remodeling process is associated with late onset of heart failure and decreased survival. ACE inhibitor therapy reduces progressive increases in LV dimensions and significantly improves the clinical course of a broad spectrum of patients with LV dysfunction.

Detection of coronary artery disease in asymptomatic patients with type 2 diabetes mellitus.

Unlabelled: In type 2 diabetes mellitus (DM2) patients, coronary artery disease (CAD) generally is detected in an advanced stage, whereas an asymptomatic stage is commonly missed. Abnormal myocardial perfusion during stress myocardial contrast echocardiography (MCE) and significant CAD were similar, irrespective of risk factor (RF) profile in our patients, but coronary anatomy differed. An "aggressive" diagnostic approach, requiring coronary angiography in asymptomatic DM2 patients with < or = 1 associated RF for CAD and abnormal MCE, identified silent CAD, characterized by a more favorable angiographic anatomy.

Effects of different insulin regimes on postprandial myocardial perfusion defects in type 2 diabetic patients.

Objective: Postprandial glycemia is an independent risk factor for cardiovascular disease that is more powerful than fasting glycemia and determines myocardial perfusion defects in type 2 diabetes. We examined the efficacy of two different insulin regimes (regular insulin and insulin analog) in controlling postprandial hyperglycemia and in preventing myocardial perfusion abnormalities.

Research Design And Methods: A total of 20 consecutive type 2 diabetic patients and 20 control subjects were enrolled in this randomized, three-way, cross-over, placebo-controlled study.

Oral amino acids in elderly subjects: effect on myocardial function and walking capacity.

Background: With advancing age the risk of developing serious nutritional deficiencies increases, and disturbances to the actions of insulin and insulin-like growth factor, coupled with reduced protein/amino acid (AA) intake, impair protein synthesis in muscles.

Objective: To assess the effects of administering oral AAs on walking capacity and perceived walking impairment, isometric muscular strength, and myocardial function at rest and during isometric exercise.

Methods: One hundred elderly subjects (aged >65 years) with reduced physical activity were randomized to receive an oral AA mixture (12 g/day) or placebo for 3 months.

Postprandial myocardial perfusion in healthy subjects and in type 2 diabetic patients.

Background: In diabetic patients, postprandial hyperglycemia is a more powerful risk factor for cardiovascular disease than fasting hyperglycemia itself. A negative influence of acute hyperglycemia on systemic endothelial function (brachial artery) has been shown. However, myocardial perfusion during postprandial hyperglycemia has not been investigated.

Long-term survival and functional results after aortic valve replacement in asymptomatic patients with chronic severe aortic regurgitation and left ventricular dysfunction.

Objectives: We examined the influence of medical treatment on the results of surgery in terms of long-term survival and functional results in patients with chronic, severe aortic regurgitation (AR).

Background: Asymptomatic patients with AR and a reduced left ventricular ejection fraction (LVEF) are at high risk because of a higher-than-expected long-term mortality. The influence of preoperative medical therapy on the outcome after aortic valve replacement (AVR) is not well known.

Abnormal myocardial perfusion and contractile recruitment during exercise in type 1 diabetic patients.

Background: No data are available on the relationship between myocardial perfusion and left ventricular (LV) function in type 1 diabetes mellitus (T1DM), which may constitute a factor explaining the progressive contractile dysfunction to the overt phase of diabetic cardiomyopathy.

Hypothesis: This study was undertaken to test whether myocardial perfusion abnormalities are present at rest and during exercise and whether they are related to contractile dysfunction in T1DM.

Methods: Twenty-two patients with T1DM, aged 32 +/- 8.

The effects of oral amino acid intake on ambulatory capacity in elderly subjects.

Background And Aims: The combination of high prevalence of inactivity in the older population, and high risk of ill-health and disability associated with inactivity, suggests that interventions that are successful in increasing levels of activity may have a great impact on population health in later life. With advancing age, the risk of developing serious nutritional deficiencies also increases. This study was designed to assess the effects of dietary amino acid supplementation on effort tolerance in healthy elderly subjects with reduced physical activity.

Effects of oral amino acid supplementation on myocardial function in patients with type 2 diabetes mellitus.

Background: Diabetes mellitus is associated with an increased rate of cardiac amino acid catabolism that could interfere with cardiac function.

Methods: We assessed the effects of an oral amino acids mixture (AAM) on myocardial function in patients with type 2 diabetes mellitus (DM2). We studied 65 consecutive patients with DM2 who had normal resting left ventricular ejection fraction (LVEF) and did not have obstructive coronary artery disease (CAD).

Early myocardial dysfunction in the diabetic heart: current research and clinical applications.

Patients with diabetes mellitus have a high incidence of heart failure, which contributes significantly to their increased cardiovascular morbidity and mortality. One of the major complications of diabetes is the development of cardiomyopathy, a condition characterized by defects of contractile function in the absence of significant coronary artery disease or systemic hypertension. Experimental data in animal models show that contractile depression begins as early as 1 week after induction of diabetes, and the dysfunction is related to an isomyosin distribution shift from V(1) with high adenosine triphosphatase (ATPase) to V(3) with low ATPase activity.

Diabetic cardiomyopathy: a metabolic perspective.

Patients with diabetes mellitus have a >3-fold increased risk of coronary ischemic events and congestive heart failure. Several hypotheses have been provided to explain the increased cardiac vulnerability in individuals with diabetes; among these are the metabolic abnormalities. Diabetes is associated with profound changes in cardiac metabolism, characterized by diminished glucose utilization, diminished rates of lactate oxidation, and increased use of fatty acids.

Effects of treatment with sulfonylurea drugs or insulin on ischemia-induced myocardial dysfunction in type 2 diabetes.

In patients with diabetes and coronary artery disease, the potential negative role of sulfonylurea drugs is under intensive investigation. We assessed the effects of treatment with glibenclamide or insulin on the extension of left ventricular myocardial dysfunction induced by acute ischemia. Nineteen consecutive patients with type 2 diabetes and coronary artery disease entered the study.