Aim: Chronic heart failure is associated with endothelial dysfunction and insulin resistance. The aim of this investigation was to study insulin-stimulated endothelial function and glucose uptake in skeletal muscles in patients with heart failure in comparison to patients with type 2 diabetes.
Methods: Twenty-three patients with systolic heart failure and no history of diabetes, seven patients with both systolic heart failure and type 2 diabetes, 19 patients with type 2 diabetes, and ten healthy controls were included in the study. Endothelial function was studied by venous occlusion plethysmography. Insulin-stimulated endothelial function was assessed after intra-arterial infusion of insulin followed by co-infusion with serotonin in three different dosages. Forearm glucose uptake was measured during the insulin infusion.
Results: Patients with systolic heart failure had impaired insulin-stimulated endothelial function. The percentage increase in blood flow during co-infusion with insulin and serotonin dose response study was 24.74% ± 6.16%, 23.50% ± 8.32%, and 22.29% ± 10.77% at the three doses respectively, compared to the healthy control group 45.96% ± 11.56%, 67.40% ± 18.11% and 84.57% ± 25.73% (P = 0.01). Insulin-stimulated endothelial function was similar in heart failure patients and patients with type 2 diabetes, while it was further deteriorated in patients suffering from both heart failure and diabetes with a percentage increase in blood flow of 19.15% ± 7.81%, -2.35% ± 11.76%, and 5.82% ± 17.70% at the three doses of serotonin, respectively. Forearm glucose uptake was impaired in patients with heart failure compared to healthy controls (P = 0.03) and tended to be further impaired by co-existence of diabetes (P = 0.08).
Conclusion: Systolic heart failure and type 2 diabetes result in similar vascular insulin resistance and reduced muscular insulin-stimulated glucose uptake. The effects of systolic heart failure and type 2 diabetes appear to be additive.
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http://dx.doi.org/10.2147/VHRM.S25724 | DOI Listing |
Cardiovasc Revasc Med
January 2025
Division of Cardiology, Department of Medicine, University of Texas Health Sciences Center, San Antonio, TX, USA.
Background: Pulmonary hypertension (pHTN) has been associated with increased morbidity and mortality after mitral Transcatheter Edge-to-Edge Repair (TEER), but the association remains uncertain. This study aims to evaluate the impact of pHTN on cardiovascular outcomes following TEER.
Methods: We searched PubMed, Scopus, and Medline to identify studies reporting outcomes after TEER in individuals with pHTN.
Neurotherapeutics
January 2025
Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address:
Extracorporeal membrane oxygenation (ECMO) is a technique used to support severe cardiopulmonary failure. Its potential life-saving benefits are tempered by the significant risk for acute brain injury (ABI), from both primary pathophysiologic factors and ECMO-related complications through central nervous system cellular injury, blood-brain barrier dysfunction (BBB), systemic inflammation and neuroinflammation, and coagulopathy. Plasma biomarkers are an emerging tool used to stratify risk for and diagnose ABI, and prognosticate neurofunctional outcomes.
View Article and Find Full Text PDFNeurosci Lett
January 2025
Division of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi Dori, Chuo-Ku, Niigata City, Niigata 951-8510, Japan. Electronic address:
Spinal cord injuries (SCIs) can lead to severe neuropathic pain and increased risk of myocardial infarction and heart failure; therefore, the use of analgesics against SCI-induced pain should be minimized because of their adverse effects on the cardiovascular system. Ivabradine, a blocker of hyperpolarization-activated cyclic nucleotide-gated cation (HCN) channels, is used as a bradycardic agent, but recent studies focused on it as an analgesic agent for peripheral neuropathic pain. However, the analgesic effects of ivabradine on central neuropathic pain, such as SCI-induced pain, have not been examined.
View Article and Find Full Text PDFJ Neurol Sci
December 2024
Emergency Department, Stroke Unit, Sapienza University of Rome, Rome, Italy. Electronic address:
Background And Aims: Iron deficiency (ID) is a prognostic factor in heart failure and acute coronary syndrome. However, its role in cerebrovascular diseases is controversial. We aimed to determine the impact of ID on the functional outcome of acute ischemic stroke patients.
View Article and Find Full Text PDFCardiovasc Revasc Med
December 2024
Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA, United States of America; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, United States of America. Electronic address:
Background: There has been a significant increase in the utilization of non-mechanical valves in the aortic position over time. However, details in reinterventions after aortic root replacement (ARR) with non-mechanical prosthesis were limited in the literature, despite the potential importance of reinterventions in the lifetime management of aortic valve disease.
Methods: This is a single-center retrospective study, identifying all patients who underwent ARR with allograft, xenografts, and stented bioprosthetic valved conduit from 2010 to 2020.
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