Effect of lifestyle intervention plus rosiglitazone or placebo therapy on left
ventricular mass assessed with cardiovascular magnetic resonance in the metabolic
syndrome.
Author(s): Roes SD, Dehnavi RA, Westenberg JJ, Lamb HJ, Mertens BJ, Tamsma JT, de Roos A.
Affiliation(s): Department of Radiology, Leiden University Medical Center, Leiden, The
Netherlands.
Publication date & source: 2011, J Cardiovasc Magn Reson. , 13:65
BACKGROUND: To evaluate the effect of lifestyle intervention in conjunction with
rosiglitazone or placebo therapy on left ventricular (LV) mass, using
cardiovascular magnetic resonance (CMR) in the metabolic syndrome.
METHODS: The present study was a pre-specified substudy of a double-blind
randomized controlled trial evaluating the effect of lifestyle intervention in
conjunction with rosiglitazone or placebo therapy on carotid artery
atherosclerosis in the metabolic syndrome. From this original study population,
10 subjects from the placebo group and 10 from the rosiglitazone group were
randomly selected. At baseline and follow-up (52 weeks), clinical and laboratory
measurements were assessed and a CMR-examination was performed to evaluate LV
mass indexed for body surface area (LV mass-I). Subsequently, the effect of
therapy (rosiglitazone vs. placebo) and clinical and laboratory variables on LV
mass-I was evaluated.
RESULTS: In both groups, body mass index, waist circumference, systolic and
diastolic blood pressure significantly decreased during follow-up. Interestingly,
LV mass-I significantly decreased in the placebo group (48.9 ± 5.3 g/m2 vs. 44.3
± 5.6 g/m2, p < 0.001) indicating reverse remodeling, whereas LV mass-I remained
unchanged in the rosiglitazone group (54.7 ± 9.9 g/m2 vs. 53.7 ± 9.2 g/m2, p =
0.3). After correction for systolic and diastolic blood pressure and
triglyceride, the kind of therapy (rosiglitazone vs. placebo) remained the only
significant predictor of LV mass-I reduction.
CONCLUSIONS: Lifestyle intervention resulted in a reduction of LV mass-I in the
metabolic syndrome, indicating reverse remodeling. However, rosiglitazone therapy
may have inhibited this positive reverse remodeling.
TRIAL REGISTRATION: Current Controlled Trials ISRCTN54951661.
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