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 Presentation

"Insulin resistance and the heart : A target for treatment ?"

Dr. Lawrence Young (biography)
English - 2003-03-29 - 46 minutes
(38 slides)
(5 questions)

Summary :
A high rate of myocardial metabolism is needed to generate energy in order to sustain cardiac contractile activity. Typically, energy generation occurs through the metabolism of free fatty acids, glucose, and lactate. However, in insulin-resistance and diabetic individuals, excessive free fatty acid metabolism occurs in the heart. Pharmacologic manipulation of myocardial metabolism may be beneficial in these patients. There is evidence that the thiazolidinediones, aside from exerting effects on fat and skeletal muscles, also act on the myocardium by reducing circulating fatty acid concentrations. Animal studies have shown that the thiazolidinediones influence the expression anf function of glucose transporters in the heart, leading to improved glucose metabolism. Recent experiments have also shown that administration of thiazolidinediones may protect against myocardial injury associated with ischemia and may improve recovery of function during the post-ischemic period. This presentation provides a review of the potential beneficial effects of the thiazolidinediones on myocardial metabolism.

Learning objectives :
The potential beneficial effects of the TZDs on myocardial glucose and free fatty acid metabolism.

Bibliographic references :
J Cardiovasc Pharmacol Ther 2002 Oct;7(4):207-10 Thiazolidinediones Could Improve Endothelial Dysfunction and Risk of Premature Coronary Heart Disease in HIV-Infected Patients.

Carrillo-Jimenez R, Lamas GA, Hennekens CH.

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Circulation 2003 Mar 18;107(10):1448-53
Obesity, insulin resistance, diabetes, and cardiovascular risk in children: an American Heart Association scientific statement from the Atherosclerosis, Hypertension, and Obesity in the Young Committee (Council on Cardiovascular Disease in the Young) and the Diabetes Committee (Council on Nutrition, Physical Activity, and Metabolism).

Steinberger J, Daniels SR; American Heart Association Atherosclerosis, Hypertension, and Obesity in the Young Committee (Council on Cardiovascular Disease in the Young) and the Diabetes Committee (Council on Nutrition, Physical Activity, and Metabolism).

Full text article at :

http://circ.ahajournals.org/cgi/content/full/107/10/1448

   


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