Key result
Glucagon-like peptide-1 improves left ventricular ejection fraction and functional status in patients with heart failure, representing a promising therapeutic target for insulin resistance.
Insulin resistance contributes to heart failure progression in the elderly, and targeting this pathway with GLP-1 may offer therapeutic benefits.
May support GLP-1 in insulin-resistant HF; leaves open RCTs to confirm benefit before practice change.
Heart failure is a disease of advancing age. Despite the advent of effective therapies, the overall outcome among the elderly has not been altered significantly. Aging is also associated with whole body and myocardial insulin resistance. Insulin resistance is accompanied by increased sympathetic nervous system activation and increased nonesterified fatty acid (NEFA) uptake in excess of NEFA oxidation, leading to NEFA accumulation within cardiac myocytes and mitochondria. Myocardial mitochondria demonstrate increased reactive oxygen species and calcium sequestration and decreased protein expression leading to impaired energetic reserves. Although these alterations in myocardial mitochondrial function lead to an accelerated course of heart failure, these changes can be modified and protect against exacerbation of heart failure. In particular, glucagon-like peptide-1, a naturally occurring incretin, has been shown to improve left ventricular ejection fraction and functional status in patients. Further investigation must be pursued for this promising novel therapeutic target for heart failure.
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Sinha et al. (2011) conducted a review in Heart failure. Glucagon-like peptide-1 was evaluated. Glucagon-like peptide-1 improves left ventricular ejection fraction and functional status in patients with heart failure, representing a promising therapeutic target for insulin resistance.
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