Cardiac and skeletal muscle insulin resistance in patients with coronary heart disease. A study with positron emission tomography.

Paternostro, Giovanni; Camici, Paolo G.; Lammerstma, Adriaan A.; Marinho, Norma Vasconcelos Saldanha; Baliga, Ragavendra R.; Kooner, J; Radda, George K.; Ferrannini, Ele

doi:10.1172/jci119015

Cited by 145 publications

(120 citation statements)

References 56 publications

(43 reference statements)

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“…Then, the patients inhaled 15 Olabelled carbon monoxide (C 15 O, 3.0 MBq/ml) for 4 min at a flow rate of 500 ml/min and a single frame scan was used to image the blood pool [11]. After allowing 10 min for decay of 15 O radioactivity, 15 O-water (740 MBq) was injected as an intravenous bolus over 20 s [11]. A primed-continuous (40 mU .…”

Section: Methodsmentioning

confidence: 99%

“…A primed-continuous (40 mU . m -2. min -1 ) infusion of insulin was started immediately after the first 15 O-water scan, and a 150-min euglycaemic hyperinsulinaemic clamp was carried out [11,13]. After about an hour (65±5 min) had elapsed from the start of the clamp, a second assessment of MBF was done.…”

Section: Methodsmentioning

confidence: 99%

“…After about an hour (65±5 min) had elapsed from the start of the clamp, a second assessment of MBF was done. Immediately thereafter 18 FDG (185 MBq) was infused over 2 min and a dynamic scan was carried out [11].…”

Section: Methodsmentioning

confidence: 99%

“…All sinograms were corrected for tissue attenuation and reconstructed through standard reconstruction algorithms. Image generation and model-fitting computations were done on a SUN Ultra 10 workstation (Sun Microsystems, Mountain View, Calif., USA) as described previously [11] by using dedicated software running in the MATLAB programming language (The MathWorks, Natick, Mass., USA).…”

Section: Methodsmentioning

confidence: 99%

“…Previous evidence [9] has suggested a direct action of insulin by showing that, during cardiac catheterisation in patients with coronary artery disease (six of whom were hypertensive), local intracoronary insulin infusion led to an increase in coronary sinus blood flow without an increase in oxygen demand. Both coronary artery disease and hypertension are associated with insulin resistance [10,11]. Unfortunately, comparison with a group of healthy people was not undertaken.…”

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confidence: 99%

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Mismatch between insulin-mediated glucose uptake and blood flow in the heart of patients with Type II diabetes

et al. 2002

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Aims/hypothesis. We investigated the effect of physiological hyperinsulinaemia on global and regional myocardial blood flow and glucose uptake in five patients with Type II (non-insulin-dependent) diabetes mellitus and seven healthy control subjects. Methods. Myocardial blood flow was assessed by positron emission tomography with oxygen-15 labelled water (H 2 15 O) either before or after 1 h of euglycaemic hyperinsulinaemia. Myocardial glucose uptake was assessed by positron emission tomography and fluorine-18 labelled fluorodeoxyglucose ( 18 FDG). Results. During hyperinsulinaemia, myocardial blood flow increased from 0.91±0.03 to 1.00±0.03 ml . min -1 . g -1 in control subjects (p<0.005) and from 0.81±0.02 to 0.95±0.04 ml . min -1. g -1 in diabetic patients (p<0.0005). Corresponding glucose uptakes were 0.56±0.01 and 0.36±0.02 µmol . min -1. g -1 (p<0.0001), respectively. During hyperinsulinaemia, the regional distribution of myocardial blood flow and glucose uptake showed higher values in the septum and anterolateral wall (short axis) and in the mid-ventricle (long axis) in control subjects, and insulin action was circumscribed to these regions. In diabetic patients, the regional distribution of glucose uptake was similar; however, insulin-induced increase of myocardial blood flow was mainly directed to the postero-inferior areas (short axis) and to the base (long axis) of the heart, thus cancelling the predominance of the anterior wall observed before insulin administration. Conclusion/interpretation. These results provide evidence that insulin-mediated regulation of global myocardial blood flow is preserved in Type II diabetic patients. In contrast, the regional re-distribution of myocardial blood flow induced by insulin is directed to different target areas when compared with healthy subjects, thereby resulting in a mismatch between blood flow and glucose metabolism. [Diabetologia (2002[Diabetologia ( ) 45:1404[Diabetologia ( -1409 Keywords Insulin, diabetes, myocardial glucose metabolism, myocardial perfusion, positron emission tomography. The availability of non-invasive quantification of myocardial blood flow (MBF) with positron emission tomography (PET) has re-opened the long debated issue concerning the role of insulin in the regulation of myocardial perfusion. A better understanding of this issue carries important pathophysiological implications on the relation between insulin resistance and enhanced cardiovascular risk. In previous studies [1,2,3,4,5,6], the use of invasive techniques and/or anaesthesia could have introduced confounding factors, such as variable degrees of sympathetic activation and circulating NEFA concentrations. Using PET and oxygen-15 labelled water, we have shown that in healthy

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Mismatch between insulin-mediated glucose uptake and blood flow in the heart of patients with Type II diabetes

et al. 2002

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Simultaneous gradient‐echo/spin‐echo EPI of graded ischemia in human skeletal muscle

Donahue

Kylen

Guven

et al. 1998

Magnetic Resonance Imaging

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The goal of this study was to evaluate the usefulness of blood oxygenation level-dependent (BOLD) methodologies to provide temporal and spatial information about skeletal muscle perfusion. A simultaneous gradient echo (GE) and spin-echo (SE) imaging sequence (GE/SE) with alternating TE was used to acquire images of leg skeletal muscle throughout a stepped reactive hyperemia paradigm. The change in both the GE and SE relaxation rates (deltaR2*, deltaR2) measured during ischemia and reactive hyperemia scaled with the duration of cuff inflation (the ischemic period) plateaued for cuff inflations lasting longer than 120 seconds and were greater in soleus muscle than in gastrocnemius. The ratio deltaR2*/deltaR2 was found to be less during the reactive hyperemia period relative to ischemia. Considering that a greater proportion of capillary vessels are perfused during reactive hyperemia than during ischemia, this finding suggests that magnetic susceptibility methodologies, with their dependence on compartment size, may provide a measure of the relative distribution of small and large vessels in skeletal muscle.

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Influence of perfusion on high‐intensity focused ultrasound prostate ablation: A first‐pass MRI study

Wiart

Curiel

Gelet

et al. 2007

Magnetic Resonance in Med

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Cardiac and skeletal muscle insulin resistance in patients with coronary heart disease. A study with positron emission tomography.

Cited by 145 publications

References 56 publications

Mismatch between insulin-mediated glucose uptake and blood flow in the heart of patients with Type II diabetes

Mismatch between insulin-mediated glucose uptake and blood flow in the heart of patients with Type II diabetes

Simultaneous gradient‐echo/spin‐echo EPI of graded ischemia in human skeletal muscle

Influence of perfusion on high‐intensity focused ultrasound prostate ablation: A first‐pass MRI study

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