Rosiglitazone, but Not Pioglitazone, Improves Myocardial Systolic Function in Type 2 Diabetic Patients: A Tissue Doppler Study

OBJECTIVE: Despite many potential benefits, thiazolidinedione (TZD) use has been associated with increased exacerbation rate of heart failure due to fluid retention. In our study, the effect of rosiglitazone and pioglitazone on myocardial function in patients with type 2 diabetes mellitus (DM) and normal left ventricular systolic function was evaluated by both conventional echocardiography and tissue Doppler imaging (TDI). METHODS: Forty patients who were diagnosed type 2 DM according to the American Diabetes Association criteria were included in the study. After baseline evaluation, all patients were randomly assigned to receive either rosiglitazone 4 mg twice daily or pioglitazone 30 mg daily for 4 months. Blood samples were taken and detailed pulsed-wave and tissue Doppler echocardiographic examination was performed at baseline and 4 months after TZD therapy. RESULTS: Left ventricular systolic velocity (Sm) values were found to be significantly increased in the rosiglitazone group (+2.6 + or - 0.7 cm/sec, P < 0.0001), while they remained unchanged in the pioglitazone group. Left ventricular early diastolic velocity (Em) increased at the same extent in both groups after treatment (rosioglitazone: +0.7 + or - 0.7 cm/sec; pioglitazone: +0.5 + or - 0.4 cm/sec, P < 0.05). CONCLUSION: In conclusion, while rosiglitazone and pioglitazone therapy improved metabolic parameters, blood pressure values and diastolic function similarly, in type 2 diabetic patients, only rosiglitazone improved systolic myocardial function significantly. (Echocardiography 2010;27:512-518).