Glucose and the metabolism of ischaemic myocardium

Opie, L.H.

doi:10.1016/s0140-6736(95)91080-8

Cited by 37 publications

(17 citation statements)

References 7 publications

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“…Our results are relevant to the long debated question of the efficacy of glucose-insulin-potassium therapy in myocardial infarction (63,64). A recent study (65) has shown that the infusion of glucose and insulin after a myocardial infarction improves the long-term prognosis of diabetic patients.…”

Section: Discussionmentioning

confidence: 58%

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

Paternostro¹,

Camici²,

Lammerstma³

et al. 1996

J. Clin. Invest.

145

106

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Patients with coronary artery disease or heart failure have been shown to be insulin resistant. Whether in these patients heart muscle participates in the insulin resistance, and whether reduced blood flow is a mechanism for such resistance is not known. We measured heart and skeletal muscle blood flow and glucose uptake during euglycemic hyperinsulinemia (insulin clamp) in 15 male patients with angiographically proven coronary artery disease and chronic regional wall motion abnormalities. Six age-and weightmatched healthy subjects served as controls. Regional glucose uptake was measured by positron emission tomography using [

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Section: Discussionmentioning

confidence: 58%

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

Paternostro¹,

Camici²,

Lammerstma³

et al. 1996

J. Clin. Invest.

145

106

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“…The concept of metabolic protection of the ischemic myocardium hinges on the fact that glucose can be metabolized anaerobically and can thereby provide glycolytic ATP in the cytosolic compartment. 8 Because glucose uptake is promoted by insulin, infusions of glucose and insulin with potassium (GIK) were initially evaluated in AMI by Sodi Pallares in 1962. 9 …”

mentioning

confidence: 99%

Metabolic Modulation of Acute Myocardial Infarction

Dı́az

Ea²,

Ls³

et al. 1998

Circulation

406

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on behalf of the ECLA (Estudios Cardiológicos Latinoamérica) Collaborative Group* Background-Several trials have been performed in the past using glucose, insulin, and potassium infusion (GIK) for the treatment of acute myocardial infarction (AMI). Because of continuing uncertainty about the potential role of this therapeutic intervention, we conducted a randomized trial to evaluate the impact of a GIK solution during the first hours of AMI. Methods and Results-Four hundred seven patients with suspected AMI admitted within 24 hours of symptoms onset were enrolled. In a ratio of 2:1, 268 patients were allocated to receive GIK (high-or low-dose) and 139 to receive control. Phlebitis and serum changes in the plasma concentration of glucose or potassium were observed more often with GIK. A trend toward a nonsignificant reduction in major and minor in-hospital events was observed in patients allocated to GIK. In 252 patients (61.9%) treated with reperfusion strategies, a statistically significant reduction in mortality (relative risk [RR] 0.34; 95% CI: 0.15 to 0.78; 2Pϭ0.008) and a consistent trend toward fewer in-hospital events in the GIK group were observed. Conclusions-Our results confirm that a metabolic modulation strategy in the first hours of an AMI is feasible, applicable worldwide, and has mild side effects. The statistically significant mortality reduction in patients who underwent a reperfusion strategy might have important implications for the management of AMI patients. It is now essential to perform a large-scale trial to reliably determine the magnitude of benefit.

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“…They observed that the rate of glycolysis in myocardial ischemia is primarily due to the rate of glucose delivery and subsequent transport into the cell. They did not entirely exclude concomitant enzyme inhibition, but increase of glucose delivery appeared to be of greater importance [12,13]. Glucose oxidation and glycogen resynthesis during ischemia promote the return of normal contractile function in the postischernic heart [14].…”

Section: Substrate Metabolismmentioning

confidence: 99%

“…Numerous articles have appeared in the literature testifying to the value of glucose-insulin-potassium treatment in acute myocardial infarction. Opie has summarized those in two editorials [12,13]. He described a reduction of 28% in mortality with 49 lives saved per thousand patients treated [13].…”

Section: Substrate Metabolismmentioning

confidence: 99%

Some aspects of biochemistry of myocardial infarction

Bing¹

2001

CMLS, Cell. Mol. Life Sci.

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This review deals with biochemical changes in infarcted heart muscle. Two main topics are emphasized: changes in substrate metabolism and in myocardial nitric oxide (NO), and prostacyclin and thromboxane formation. Alterations in glucose metabolism in infarcted heart are discussed with special reference to its myocardial utilization in ischemia. The biochemical basis of the increase in NO and prostanoids and the relationship between the enzyme producing nitric oxide (NOS) and cyclooxygenases (COX) responsible for formation of prostanoids are described. The relevance of these findings to clinical conditions and to angiogenesis in heart muscle are stressed.

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Glucose and the metabolism of ischaemic myocardium

Cited by 37 publications

References 7 publications

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

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

Metabolic Modulation of Acute Myocardial Infarction

Some aspects of biochemistry of myocardial infarction

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