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European Heart Journal Advance Access originally published online on April 21, 2005
European Heart Journal 2005 26(12):1205-1212; doi:10.1093/eurheartj/ehi271
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© The European Society of Cardiology 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oupjournals.org

Effects of insulin on left ventricular function during dynamic exercise in overweight and obese subjects

Ferdinando C. Sasso1,3,*, Ornella Carbonara1,3, Rodolfo Nasti1,3, Raffaele Marfella1,3, Katherine Esposito1,3, Pierfrancesco Rambaldi2,3, Luigi Mansi2,3, Teresa Salvatore1,3, Roberto Torella1,3 and Domenico Cozzolino1,3

1Department of Geriatrics and Metabolic Diseases, Second University of Naples, Naples, Italy
2Institute of Nuclear Medicine, Faculty of Medicine, Second University of Naples, Naples, Italy
3Excellence Centre for Cardiovascular Disease, Second University of Naples, Naples, Italy

Received 2 July 2004; revised 18 February 2005; accepted 17 March 2005; online publish-ahead-of-print 21 April 2005.

* Corresponding author. Tel: +39 081 5666707; fax: +39 081 5666736. E-mail address: ferdinando.sasso{at}unina2.it

See page 1150 for the editorial comment on this article (doi:10.1093/eurheartj/ehi063)

Aims We designed this study in order to determine the effect of insulin on cardiac function in overweight and obese subjects during exercise.

Methods and results The cardiac function of 62 normal glucose tolerant subjects, aged 30–40 and divided into normal weight (group 1, n=22, BMI 20–24.9 kg/m2), overweight (group 2, n=20, BMI 25–29.9 kg/m2), and obesity (group 3, n=20, BMI 30–35 kg/m2) was evaluated at rest and during dynamic exercise through angiocardioscintigraphy, when on hyperinsulinaemic euglycaemic clamp (test A) and when on normal saline infusion (test B). Left ventricular function at rest was statistically greater (P<0.05) in both tests in overweight and obese subjects compared with normal weight controls, with no statistical difference (P=0.057) within groups between insulin and normal saline infusion. During exercise, cardiac function improved in all the subjects in both tests. The increase was lower in overweight and obese patients, even if statistically significant only in obese vs. control subjects in both tests (P<0.05). Insulin sensitivity showed a significant correlation (P≤0.001) with left ventricular ejection fraction (LVEF) at rest and with change in LVEF during clamp.

Conclusion Our findings suggest a metabolic pathogenesis for the impaired LV function in obesity.

Key Words: Insulin • Obesity • Left ventricular function • Angiocardioscintigraphy • Exercise


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