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This Article Full Text Full Text (PDF) All Versions of this Article: 292/1/H608    most recent 00516.2006v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Web of Science (3) Citing Articles via Google Scholar Google Scholar Articles by Lee, T.-M. Articles by Chang, N.-C. Search for Related Content PubMed PubMed Citation Articles by Lee, T.-M. Articles by Chang, N.-C.

Effects of sulfonylureas on left ventricular mass in type 2 diabetic patients

¹Cardiology Section, Department of Medicine, Taipei Medical University and Chi-Mei Medical Center, Tainan; ²Department of Pharmacy, National Taiwan University and Hospital, Taipei; ³Cardiology Section, Department of Surgery, E-DA Hospital and I-Shou University, Kaohsiung; and ⁴Endocrine Section and ⁵Cardiology Section, Department of Medicine, Taipei Medical University and Hospital, Taipei, Taiwan

Submitted 20 May 2006 ; accepted in final form 21 August 2006

Myocardial ATP-sensitive potassium (K_ATP) channels have been implicated in attenuating cardiac hypertrophy by modulating endothelin-1 concentrations. Sulfonylureas differ in their affinity for cardiac K_ATP channels and therefore may vary in their effects on left ventricular (LV) mass. We sought to determine the differential effects of sulfonylureas on LV mass in type 2 diabetic patients. All patients had been taking glibenclamide for more than 3 mo before being randomized to either switch to an equipotent dose of gliclazide or continue glibenclamide. A total of consecutive 240 diabetic patients were randomized into glibenclamide, gliclazide, a combination of glibenclamide and nicorandil, or gliclazide and nicorandil for 6 mo. In the gliclazide-treated group, the LV mass index was significantly decreased compared with that in the glibenclamide-treated groups. Nicorandil administration significantly reduced LV mass in glibenclamide-treated patients compared with patients treated with glibenclamide alone. Measurements of endothelin-1 concentrations mirrored the functional status of K_ATP channel. Multivariate analysis revealed that regression of LV mass was significantly correlated only with the changes in endothelin-1 (P < 0.0001). Our results show that K_ATP channels may play a pathogenetic role, probably through an endothelin-1-dependent pathway, in diabetes mellitus-related ventricular hypertrophy. Patients treated with gliclazide may have a beneficial effect in attenuating ventricular mass.

adenosine 5'-triphosphate-sensitive potassium channels; diabetes mellitus; glibenclamide; gliclazide; ventricular hypertrophy