| Cardiac metabolic and hemodynamic effects of insulin in patients with coronary artery disease. | |
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MedLine Citation:
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PMID: 2670646 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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To assess the effects of insulin in stable coronary artery disease (CAD), 2 U i.v. insulin was given to 9 control and 10 CAD patients during coronary sinus catheterization. Hemodynamic and metabolic data were obtained before and for 90 min after insulin injection. Insulin induced no changes in heart rate, mean aortic pressure, rate-pressure product, coronary sinus flow, or coronary resistance. Metabolic changes were similar in both groups and included 1) 30% decrease of arterial glucose (P less than .001) and 3-fold increase of myocardial glucose uptake (P less than .001), 2) 1.5- to 2.5-fold elevation of arterial lactate (P less than .001) and myocardial lactate usage (P less than .001), respectively, 3) 50-70% suppression of arterial levels (P less than .001) and myocardial uptake of free fatty acids (P less than .01), and 4) 10% reduction of myocardial net oxygen consumption (P less than .05). Myocardial citrate efflux increased in the CAD patients (P less than .05), whereas alanine release rose only in control patients (P less than .01), suggesting that glucose enters glycogen production in the CAD patients and pyruvate production in the control patients to a high degree. Myocardial glutamate uptake remained unchanged. In conclusion, insulin sensitivity was not altered in CAD. The insulin-induced shift from myocardial free fatty acid to carbohydrate usage may be beneficial to the ischemic heart by increasing glycogen stores, saving oxygen, and inhibiting an excess free-fatty acid concentration, which may be toxic during ischemia. |
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Authors:
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A Thomassen; T T Nielsen; J P Bagger; P Henningsen |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Diabetes Volume: 38 ISSN: 0012-1797 ISO Abbreviation: Diabetes Publication Date: 1989 Sep |
Date Detail:
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Created Date: 1989-10-03 Completed Date: 1989-10-03 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0372763 Medline TA: Diabetes Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1175-80 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiology, Skejby Sygehus, North Arhus, Denmark. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Alanine
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metabolism Blood Glucose / analysis Citrates / metabolism Citric Acid Coronary Disease / drug therapy*, metabolism, physiopathology Drug Evaluation Fatty Acids, Nonesterified / metabolism Female Glutamates / metabolism Heart / drug effects*, physiopathology Heart Catheterization Hemodynamics / drug effects* Insulin / metabolism, therapeutic use* Lactates / metabolism Lactic Acid Male Myocardium / metabolism* Oxygen Consumption / drug effects Time Factors |
| Chemical | |
Reg. No./Substance:
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0/Blood Glucose; 0/Citrates; 0/Fatty Acids, Nonesterified; 0/Glutamates; 0/Lactates; 11061-68-0/Insulin; 50-21-5/Lactic Acid; 56-41-7/Alanine; 77-92-9/Citric Acid |
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