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

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 ¼ 22, BMI 20–24.9 kg/m 2 ), overweight (group 2, n ¼ 20, BMI 25–29.9 kg/m 2 ), and obesity (group 3, n ¼ 20, BMI 30–35 kg/m 2 ) 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 ¼ 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.