Document Detail


Tight Glycemic Control May Increase Regenerative Potential of Myocardium during Acute Infarction.
MedLine Citation:
PMID:  22170713     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Aims:We analyzed the effects of tight glycemic control on regenerative potential of myocardium during acute myocardial infarction.Patients and Methods:Seventy-five patients with their first acute myocardial infarction undergoing coronary bypass surgery were studied: 25 patients with glycemia below 140 mg/dl served as the control group; hyperglycemic patients (glucose >140 mg/dl) were randomized to intensive glycemic control (IGC; n = 20; glucose goal, 80-140 mg/dl), conventional glycemic control (CGC; n = 20; glucose goal, 180-200 mg/dl), or glucose-insulin-potassium (GIK; n = 10; glucose goal, 180-200 mg/dl) for almost 3 d before surgery, using insulin infusion followed by sc insulin treatment. During surgery, myocyte precursor cells (MPC) (c-kit/MEFC2/GATA4-positive cells), oxidation of MPC DNA (c-kit/8-hydroxydeoxyguanosine-positive cells), senescent MPC (c-kit/p16(INK4a)-positive cells), and cycling cardiomyocytes (Ki-67-positive cells) were analyzed in biopsy specimens taken from the peri-infarcted area.Results and Discussion: Before surgery, plasma glucose reduction was greater in the IGC group than in the CGC and GIK groups (P < 0.001 for both). IGC patients had higher MPC (P < 0.01) and cycling myocytes (P < 0.01), as well as less oxidized (P < 0.01) and senescent MPC (P < 0.01) in peri-infarcted specimens compared with both CGC and GIK patients. Tight glycemic control, by reducing senescent MPC, may increase regenerative potential of the ischemic myocardium.
Authors:
Raffaele Marfella; Ferdinando Carlo Sasso; Federico Cacciapuoti; Michele Portoghese; Maria Rosaria Rizzo; Mario Siniscalchi; Ornella Carbonara; Franca Ferraraccio; Michele Torella; Antonello Petrella; Maria Luisa Balestrieri; Paola Stiuso; Giannantonio Nappi; Giuseppe Paolisso
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-14
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  -     ISSN:  1945-7197     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Geriatrics and Metabolic Diseases (R.M., F.C., M.R.R., M.S., G.P.), Second University of Naples, 80138 Naples, Italy; Department of Internal and Experimental Medicine (F.C.S., O.C.), Center of Cardiovascular Excellence, Second University of Naples, 80138 Naples, Italy; Cardiovascular Surgery Unit (M.P.), Sassari Hospital, 07100 Sassari, Italy; Department of Clinical, Public, and Preventive Medicine (F.F.), and Division of Cardiac Surgery (M.T., G.N.), Second University of Naples, 80138 Naples, Italy; Department of Pharmaceutical Sciences (A.P.), University of Salerno, 84084 Salerno, Italy; and Department of Biochemistry and Biophysics (M.L.B., P.S.), Second University of Naples, 80138 Naples, Italy.
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