Defining the Role of Insulin Resistance in 'Idiopathic' Dilated Cardiomyopathy

Inclusion Criteria:

• Diagnosis of nonischemic dilated cardiomyopathy, current NYHA class I-II congestive heart failure
• History of Stage C-D heart failure with EF ≤ 40% during the course of the disease
• Treatment with a stable comprehensive heart failure regimen for at least 3 months (including beta-blockers and ACE-inhibitors or angiotensin receptor blockers unless intolerant)
• Age > 18 yrs

Exclusion Criteria:

• Cardiomyopathy due to one of the following:

  • Ischemic heart disease
  • Primary valvular lesion
  • Hypertrophic cardiomyopathy
• Cardiac resynchronization within the last 3 months
• Transaminase values > 2.5 x upper limit of normal or history of liver disease

• Diagnosis of diabetes mellitus by:

  • Diabetes previously diagnosed per patient history
  • 2 or more fasting glucose values > 125 mg/dl
• Current NYHA class III or IV heart failure
• Serum creatinine > 1.6 mg/dl
• History of heart transplantation
• Pregnancy or active breast feeding
• Hospitalization for decompensated heart failure within 30 days prior to enrollment.