This study tested whether ATP-dependent K ؉ channels (K ATP channels) are an important mechanism of functional coronary hyperemia in conscious, instrumentimplanted diabetic dogs. Data were collected at rest and during exercise before and after induction of diabetes with alloxan monohydrate (40 -60 mg/kg intravenously). K ATP channels were inhibited with glibenclamide (1 mg/kg intravenously). In nondiabetic dogs, arterial plasma glucose concentration increased from 4.8 ؎ 0.3 to 21.5 ؎ 2.2 mmol/l 1 week after alloxan injection. In nondiabetic dogs, exercise increased myocardial oxygen consumption (MVO 2 ) 3.4-fold, myocardial O 2 delivery 3.0-fold, and heart rate 2. N umerous investigations have focused on the role of ATP-dependent K ϩ (K ATP ) channels in coronary blood flow regulation (1-14). These studies indicate that K ATP channels are important in regulating coronary vascular resistance under baseline conditions (3-10), during hypoxic coronary vasodilation (11,12), and during reactive coronary hyperemia (1,4,13). However, it does not appear that K ATP channels are required to increase coronary blood flow when myocardial metabolism is increased (3)(4)(5)7,8).Recently, Kersten et al. (14) found that diabetes enhanced K ATP channel-mediated coronary vasodilation of coronary arterioles, suggesting that K ATP channels are important in local metabolic coronary vasodilation in diabetes. Supporting this notion are the results of Shimoni et al. (15) showing that the half-maximal inhibitory concentration (IC 50 ) for ATP-dependent inhibition of K ATP channels was approximately twofold higher for channels from diabetic rat hearts. If there is an increase of K ATP channel activity in diabetes, then oral hypoglycemic agents such as glibenclamide (Glyburide or Diabeta), which are K ATP channel antagonists, could seriously impair control of coronary blood flow, especially when myocardial oxygen demand is elevated. Despite this fact, no study has examined whether K ATP channels contribute to metabolic coronary vasodilation in an intact diabetic model. Furthermore, characterizing mechanisms that regulate coronary vascular tone is particularly important since coronary flow reserve (16 -19), functional coronary hyperemia (18), and the balance between coronary blood flow and myocardial metabolism (20) are impaired in diabetic subjects. Accordingly, this study was designed to determine whether K ATP channels contribute to local metabolic coronary vasodilation in diabetic subjects. Experiments were conducted at rest and during graded treadmill exercise, with and without K ATP channel blockade (glibenclamide, 1 mg/kg i.v.) (7,8), in chronically instrument-implanted dogs before and after induction of diabetes with alloxan monohydrate (40 -60 mg/kg i.v.) (21).
RESEARCH DESIGN AND METHODSSurgical preparation. This investigation was approved by the Institutional Animal Care and Use Committee and was conducted in accordance with the Guide for the Care and Use of Laboratory Animals (National Institutes of Health publ. no. 85-23, revise...