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Title: Thiazolidinediones and congestive heart failure--exacerbation or new onset of left ventricular dysfunction?
Austin Authors: Srivastava, Piyush M ;Calafiore, Paul ;MacIsaac, Richard J;Hare, David L ;Jerums, George ;Burrell, Louise M 
Affiliation: Department of Medicine, University of Melbourne, Victoria, Australia
Issue Date: 1-Aug-2004
Publication information: Diabetic Medicine : A Journal of the British Diabetic Association; 21(8): 945-50
Abstract: Patients with diabetes mellitus have a high incidence of coronary heart disease and congestive heart failure (CHF). Thiazolidinediones (TZD) are a new class of pharmacological agents for the treatment of Type 2 diabetes mellitus, which have many beneficial cardiovascular effects. Peripheral oedema and weight gain have been reported in 4.8% of subjects on TZDs alone, with a higher incidence noted in those receiving combination insulin therapy (up to 15%), but there is limited data on the occurrence of CHF.In this paper, we report on six cases of TZD-induced fluid retention with symptoms and signs of peripheral oedema and/or CHF that occurred in subjects attending our diabetic clinic. The predominant finding in all cases was of diastolic dysfunction. All subjects were obese and hypertensive, with 5/6 having the additional risk factor of LVH, 5/6 subjects had microvascular complications, whilst 3/6 were also on insulin therapy.We suggest that obese, hypertensive diabetics may benefit from echocardiographic screening prior to commencement of TZDs, as these agents may exacerbate underlying undiagnosed left ventricular diastolic dysfunction.
Gov't Doc #: 15270804
DOI: 10.1111/j.1464-5491.2004.01274.x
ORCID: 0000-0001-9554-6556
Journal: Diabetic medicine : a journal of the British Diabetic Association
PubMed URL: 15270804
Type: Journal Article
Subjects: Aged
Diabetes Mellitus, Type 2.drug therapy
Heart Failure.drug therapy
Middle Aged
Thiazolidinediones.therapeutic use
Ventricular Dysfunction, Left.drug therapy
Appears in Collections:Journal articles

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