Evaluation of rosiglitazone administration on cardiovascular function in severe obesity

Background: Obese patients have myocardial structural and functional alterations related to insulin resistance. Hypothesis: The purpose of the study was to analyze the effects of rosiglitazone, an insulin sensitizer agent, on cardiac morphometry and functioning. Methods: In 2 groups of sex- and age-matched, nondiabetic, obese patients (5 men and 7 women, age 19-51 y; group A: body mass index [BMI] 40.6±3.4 kg/m²; group B: BMI 42.6±2.7 kg/m²), we evaluated the basal insulin sensitivity index (HOMA[IS]), body composition by bioelectrical impedance analysis and 24-h blood pressure monitoring. Furthermore, all patients underwent conventional 2-Dimensional and color Doppler echocardiography, and pulsed-wave tissue Doppler imaging (TDI). After the baseline evaluation, all patients were put on a hypocaloric diet (70% basal metabolic rate) plus placebo if they were in group A, or plus rosiglitazone (4 mg twice daily; Avandia [GlaxoSmithKline plc., Brentford, Middlesex, United Kingdom]) if they were in group B, for 6 mo. Results: Significant decreases in body weight, total fat mass, BMI, and systolic blood pressure were registered in both groups. Rosiglitazone administration appeared more efficient in improving HOMA(IS) (mean difference: 0.30±0.19 versus 0.11±0.21, p