Ischemic heart failure mortality is not predicted by cardiac insulin resistance but by diabetes per se and coronary flow reserve: A retrospective dynamic cardiac 18F-FDG PET study

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Ischemic heart failure mortality is not predicted by cardiac insulin resistance but by diabetes per se and coronary flow reserve : A retrospective dynamic cardiac 18F-FDG PET study. / Luong, Thien Vinh; Pedersen, Mette Glavind Bülow; Kjærulff, Mette Louise Blouner Gram; Madsen, Simon; Lauritsen, Katrine Meyer; Tolbod, Lars Poulsen; Søndergaard, Esben; Gormsen, Lars Christian.

In: Metabolism: Clinical and Experimental, Vol. 123, 154862, 10.2021.

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@article{dd2878279b3941f38498944389534520,
title = "Ischemic heart failure mortality is not predicted by cardiac insulin resistance but by diabetes per se and coronary flow reserve: A retrospective dynamic cardiac 18F-FDG PET study",
abstract = "Background & aims: The connection between peripheral insulin resistance (IR) and coronary artery disease is well-established. Both are major risk factors for the development of ischemic cardiomyopathy potentially leading to heart failure (HF). Whether cardiac IR also impacts overall survival and morbidity is still debated. We therefore aimed to test if cardiac IR predicts mortality and major cardiovascular events (MACE) in patients with HF scheduled for cardiac viability testing before revascularization. Methods: This retrospective study included 131 patients with a clinical diagnosis of ischemic HF (114 (87%) male, 33 (25%) with diabetes) referred to a viability Rubidium-82 (perfusion) and dynamic 18F-Fluorodeoxyglucose (metabolism) positron emission tomography combined with computed tomography prior to a potential revascularization procedure. Cardiac IR was assessed by myocardial glucose uptake (MGU) in a remote (non-scarred) area of the left ventricle during a hyperinsulinemic-euglycemic clamp (1mIE/kg/min). Results: MGU correlated with skeletal muscle glucose uptake (p < 0.001) and whole-body glucose uptake (M-value) (p < 0.001), whereas no association was observed for individuals with diabetes. MGU did not predict the risk of death or MACE. However, both overt diabetes and reduced coronary flow reserve predicted overall survival. Conclusion: Even though diabetes and related small-vessel disease is associated with increased mortality, cardiac IR per se does not predict cardiovascular morbidity and mortality.",
keywords = "Heart failure, Insulin resistance, Myocardial glucose uptake, Positron emission tomography, Prognosis",
author = "Luong, {Thien Vinh} and Pedersen, {Mette Glavind B{\"u}low} and Kj{\ae}rulff, {Mette Louise Blouner Gram} and Simon Madsen and Lauritsen, {Katrine Meyer} and Tolbod, {Lars Poulsen} and Esben S{\o}ndergaard and Gormsen, {Lars Christian}",
note = "Copyright {\textcopyright} 2021 The Authors. Published by Elsevier Inc. All rights reserved.",
year = "2021",
month = oct,
doi = "10.1016/j.metabol.2021.154862",
language = "English",
volume = "123",
journal = "Metabolism",
issn = "0026-0495",
publisher = "Elsevier",

}

RIS

TY - JOUR

T1 - Ischemic heart failure mortality is not predicted by cardiac insulin resistance but by diabetes per se and coronary flow reserve

T2 - A retrospective dynamic cardiac 18F-FDG PET study

AU - Luong, Thien Vinh

AU - Pedersen, Mette Glavind Bülow

AU - Kjærulff, Mette Louise Blouner Gram

AU - Madsen, Simon

AU - Lauritsen, Katrine Meyer

AU - Tolbod, Lars Poulsen

AU - Søndergaard, Esben

AU - Gormsen, Lars Christian

N1 - Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.

PY - 2021/10

Y1 - 2021/10

N2 - Background & aims: The connection between peripheral insulin resistance (IR) and coronary artery disease is well-established. Both are major risk factors for the development of ischemic cardiomyopathy potentially leading to heart failure (HF). Whether cardiac IR also impacts overall survival and morbidity is still debated. We therefore aimed to test if cardiac IR predicts mortality and major cardiovascular events (MACE) in patients with HF scheduled for cardiac viability testing before revascularization. Methods: This retrospective study included 131 patients with a clinical diagnosis of ischemic HF (114 (87%) male, 33 (25%) with diabetes) referred to a viability Rubidium-82 (perfusion) and dynamic 18F-Fluorodeoxyglucose (metabolism) positron emission tomography combined with computed tomography prior to a potential revascularization procedure. Cardiac IR was assessed by myocardial glucose uptake (MGU) in a remote (non-scarred) area of the left ventricle during a hyperinsulinemic-euglycemic clamp (1mIE/kg/min). Results: MGU correlated with skeletal muscle glucose uptake (p < 0.001) and whole-body glucose uptake (M-value) (p < 0.001), whereas no association was observed for individuals with diabetes. MGU did not predict the risk of death or MACE. However, both overt diabetes and reduced coronary flow reserve predicted overall survival. Conclusion: Even though diabetes and related small-vessel disease is associated with increased mortality, cardiac IR per se does not predict cardiovascular morbidity and mortality.

AB - Background & aims: The connection between peripheral insulin resistance (IR) and coronary artery disease is well-established. Both are major risk factors for the development of ischemic cardiomyopathy potentially leading to heart failure (HF). Whether cardiac IR also impacts overall survival and morbidity is still debated. We therefore aimed to test if cardiac IR predicts mortality and major cardiovascular events (MACE) in patients with HF scheduled for cardiac viability testing before revascularization. Methods: This retrospective study included 131 patients with a clinical diagnosis of ischemic HF (114 (87%) male, 33 (25%) with diabetes) referred to a viability Rubidium-82 (perfusion) and dynamic 18F-Fluorodeoxyglucose (metabolism) positron emission tomography combined with computed tomography prior to a potential revascularization procedure. Cardiac IR was assessed by myocardial glucose uptake (MGU) in a remote (non-scarred) area of the left ventricle during a hyperinsulinemic-euglycemic clamp (1mIE/kg/min). Results: MGU correlated with skeletal muscle glucose uptake (p < 0.001) and whole-body glucose uptake (M-value) (p < 0.001), whereas no association was observed for individuals with diabetes. MGU did not predict the risk of death or MACE. However, both overt diabetes and reduced coronary flow reserve predicted overall survival. Conclusion: Even though diabetes and related small-vessel disease is associated with increased mortality, cardiac IR per se does not predict cardiovascular morbidity and mortality.

KW - Heart failure

KW - Insulin resistance

KW - Myocardial glucose uptake

KW - Positron emission tomography

KW - Prognosis

UR - http://www.scopus.com/inward/record.url?scp=85112329158&partnerID=8YFLogxK

U2 - 10.1016/j.metabol.2021.154862

DO - 10.1016/j.metabol.2021.154862

M3 - Journal article

C2 - 34375646

AN - SCOPUS:85112329158

VL - 123

JO - Metabolism

JF - Metabolism

SN - 0026-0495

M1 - 154862

ER -