Open AccessPioglitazone-induced congestive heart failure and pulmonary edema in a patient with preserved ejection fraction
Author(s) -
Vaneet Jearath,
Rajan Vashisht,
Vipul Rustagi,
Sujeet Raina,
Rajesh Sharma
Publication year - 2016
Publication title -
journal of pharmacology and pharmacotherapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.301
H-Index - 34
eISSN - 0976-5018
pISSN - 0976-500X
DOI - 10.4103/0976-500x.179363
Subject(s) - pioglitazone , heart failure , medicine , cardiology , ejection fraction , pulmonary edema , cardiac function curve , edema , peripheral edema , diabetes mellitus , lung , type 2 diabetes , endocrinology , adverse effect
Pioglitazone-induced heart failure is known in patients with underlying heart disease, but is not well documented in patients with normal left ventricular function. Pioglitazone has been very popular as it is an insulin sensitizer and insulin resistance is prevalent among Indians. Fluid retention exacerbates pre-existing heart failure or precipitates heart failure in a patient with underlying left ventricular dysfunction. However, pathogenesis of heart failure in a patient with normal left ventricular function is not known. Probably it is due to dose-related effect on pulmonary endothelial permeability, rather than alterations in left ventricular mass or ejection fraction. We report a patient who developed congestive heart failure and pulmonary edema with normal left ventricular function within 1 year of starting pioglitazone therapy. We have to be careful in monitoring all possible side effects during followup when patients are on pioglitazone therapy.