Skip to main content
SpringerLink
Log in

Troglitazone Improves Cardiac Function in Patients with Congestive Heart Failure

  • Published:
Cardiovascular Drugs and Therapy Aims and scope Submit manuscript

Abstract

Troglitazone increased cardiac output and stroke volume, as a result of decreased peripheral resistance, in diabetic patients with normal cardiac function. The cardiovascular effects of troglitazone in patients with heart failure are unknown. The aim of the study was to evaluate the cardiovascular effects of troglitazone in patients with heart failure.

Blood pressure and echocardiographic findings were evaluated before and 1, 2, 3 and 4 hours after a single dose of troglitazone (400 mg) or placebo, in eight type II diabetic patients with congestive heart failure. The plasma catecholamines and coefficient of variance of RR intervals (CVRR) were also measured.

Neither heart rate nor blood pressure changed after the administration of troglitazone. Left ventricular (LV) end-diastolic dimension did not change either, however, the LV end-systolic dimension significantly decreased compared with its baseline value and with that of the placebo group. On the other hand, the % fractional shortening and the E/A ratio increased significantly after troglitazone. The LV end-diastolic volume did not change, whereas the LV end-systolic volume significantly decreased. The stroke volume and the LV ejection fraction significantly increased compared with its baseline value and with that of the placebo group. The peripheral vascular resistance did not change after the administration of troglitazone, whereas plasma catecholamines significantly decreased, and CVRR remained unchanged in both groups.

These hemodynamic changes suggest that a single oral dose of troglitazone induced inotropy without activation of the sympathetic nervous system.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Iwamoto Y, Kuzuya T, Matsuda A, et al. Effect of new oral antidiabetic agent CS-045 on glucose tolerance and insulin secretion in patients with NIDDM. Diabetes Care 1991;14:1083–1086.

    Google Scholar 

  2. Suter SL, Nolan JJ, Wallance P, Gumbiner B, Olefsky JM. Metabolic effects of a new oral hypoglycemic agent, CS-045, in non-insulin dependent diabetic subjects. Diabetes Care 1992;15:193–203.

    Google Scholar 

  3. Nolan JJ, Ludvik B, Beerdsen P, Joyce M, Olefsky J. Improvement in glucose tolerance and insulin resistance in obese subjects treated with troglitazone. N Engl J Med 1994;331:1188–1193.

    Google Scholar 

  4. Yoshioka S, Nishino H, Shiraki T, et al. Antihypertensive effects of CS-045 treatment in obese zucker rats. Metabolism 1993;42:75–80.

    Google Scholar 

  5. Kaufman LN, Peterson MM, DeGrange LM. Pioglitazone attenuates diet-induced hypertension in rats. Metabolism 1995;44:1105–1109.

    Google Scholar 

  6. Ogihara T, Rakugi H, Ikegami H, Mikami H, Masuo K. Enhancement of insulin sensitivity by troglitazone lowers blood pressure in diabetic hypertensives. Am J Hypertens 1995;8:316–320.

    Google Scholar 

  7. Shimoyama M, Ogino K, Tanaka Y, Ikeda T, Hisatome I. Hemodynamic basis for the acute cardiac effects of troglitazone in isolated perfused rat hearts. Diabetes 1999;48:609–615.

    Google Scholar 

  8. Uchida K, Ogino K, Shimoyama M, Hisatome I, Shigemasa C. Acute hemodynamic effects of insulin-sensitizing agents in isolated perfused rat hearts.EurJ Pharmacol 2000;400:113–119.

    Google Scholar 

  9. Furuse Y, Ogino K, Shimoyama M, Sasaki N, Hisatome I. Ca2+-sensitizing effect is involved in the positive inotropic effect of troglitazone. Br J Pharmacol 2001;133:1307–1313.

    Google Scholar 

  10. Ghazzi MN, Perez JE, Antonucci TK, et al. Cardiac and glycemic benefits of troglitazone treatment in NIDDM. Diabetes 1997;46:433–439.

    Google Scholar 

  11. Schiller NB, Shah PM, Crawford M, et al. Recommendations for quantification of the left ventricle by two dimensional echocardiography: American Society of Echocardiography Committee on Standards Subcommittee. JAmSoc Echocardiogr 1989;2:358–367.

    Google Scholar 

  12. Kinugawa T, Ogino K, Noguchi N, et al. Sympathetic nervous response relative to the adenosine triphosphate supplydemand imbalance during exercise is augmented in patients with heart failure. Chest 1998;114:1295–1300.

    Google Scholar 

  13. Sung BH, Izzo JL Jr, Dandona P, Wilson MF. Vasodilatory effects of troglitazone improve blood pressure at rest and during mental stress in type 2 diabetes mellitus. Hypertension 1999;34:83–88.

    Google Scholar 

  14. Kubo S, Rector TS, Bank AJ, Williams RE, Heifetz SM. Endothelium-dependent vasodilation is attenuated in patients with heart failure. Circulation 1991;84:1589–1596.

    Google Scholar 

  15. Katz SD, Biasucci L, Sabba C, et al. Impaired endotheliummediated vasodilation in the peripheral vasculature of patients with congestive heart failure. J Am Coll Cardiol 1992;19:918–925.

    Google Scholar 

  16. Fujiwara T, Ohsawa T, Takahashi S, et al. Troglitazone, a new antidiabetic agent possessing radical scavenging ability, improved decreased skin blood flow in diabetic rats. Life Sciences 1998;63:2039–2047.

    Google Scholar 

  17. Saku K, Zhang B, Ohta T, Arakawa K. Troglitazone lowers blood pressure and enhances insulin sensitivity in Watanabe heritable hyperlipidemic rabbits. Am J Hypertens 1997;10:1027–1033.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Divisions of Cardiology, Department of Medicine, Faculty of Medicine, Tottori University, Yonago, Japan

    Kazuhide Ogino, Yoshiyuki Furuse, Kazuhiko Uchida, Masaki Shimoyama, Toru Kinugawa, Shuichi Osaki, Masahiko Kato, Akihiro Endo, Osamu Igawa, Ichiro Hisatome & Chiaki Shigemasa

  2. Clinical Laboratory, Department of Medicine, Faculty of Medicine, Tottori University, Yonago, Japan

    Shiro Ikawa

Authors
  1. Kazuhide Ogino
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yoshiyuki Furuse
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kazuhiko Uchida
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Masaki Shimoyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Toru Kinugawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Shuichi Osaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Masahiko Kato
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Akihiro Endo
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Osamu Igawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Ichiro Hisatome
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Shiro Ikawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Chiaki Shigemasa
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ogino, K., Furuse, Y., Uchida, K. et al. Troglitazone Improves Cardiac Function in Patients with Congestive Heart Failure. Cardiovasc Drugs Ther 16, 215–220 (2002). https://doi.org/10.1023/A:1020696321609

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1020696321609

Search

Navigation