Abstract 2420: Effect of Rosiglitazone on Left Ventricular Systolic and Diastolic Function and on NT-proBNP: Results of the Echocardiographic and Biomarker Substudy of the DREAM Trial
Objectives: Thiazolidinediones increase the risk of heart failure (HF). To study mechanisms, we evaluated the effects of rosiglitazone on LV systolic function (LVSF), LV volumes, LV diastolic function (LVDF) and NT-proBNP.
Methods: DREAM was a large placebo-controlled trial of rosiglitazone in people with impaired glucose tolerance and/or impaired fasting glucose, but without cardiovascular disease. In a subset of 332 DREAM trial participants, echocardiograms were obtained after a median of 3 years post randomization and NT-proBNP was measured at baseline and after 3 years. LV ejection fraction (LVEF), fractional shortening (FS), wall motion score index (WMSI), LV end-systolic (LVESV) and end-diastolic volume (LVEDV), LV mass index (LVMI), realtive wall thickness (RWT), left atrial volume index (LAVI), LVDF grade (derived from pulsed-wave mitral inflow and pulmonary vein Doppler, mitral annular tissue Doppler and LAVI) and changes from baseline in plasma NT-pro-BNP (Δ NT-proBNP) were compared between participants assigned to rosiglitazone and placebo.
Results: Participants’ mean age was 55 years, 60% were female and baseline blood pressure was 138/84 mmHg. There were no significant differences in any baseline characteristics between the study groups.Three years post-randomization participants in the rosiglitazone group had higher LVESV, LVEDV, LVMI, LAVI and advanced LV diastolic dysfunction, but LVEF, FS and WMSI did not differ between the study groups. NT-proBNP increased significantly more in the rosiglitazone vs. the placebo group.
Conclusions: Rosiglitazone causes abnormalities in LVDF, LV volumes and NT-proBNP (probably due to fluid retention), but does not cause LVSF impairment, suggesting no adverse effects on LV contractility. Measures of LV systolic, diastolic function and NT-pro-BNP in the Rosiglitazone and Placebo Groups