Impact of Type 2 Diabetes on Myocardial Insulin Sensitivity to Glucose Uptake and Perfusion in Patients with Coronary Artery Disease

Søndergaard, Hanne Maare; Bøttcher, Morten; Madsen, Mette; Schmitz, Ole; Hansen, Søren B.; Nielsen, Torsten Toftegaard; Bøtker, Hans Erik

doi:10.1210/jc.2006-1416

Cited by 12 publications

(7 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, in both HF and T2D, whole body metabolism is characterized by increased levels of circulating glucose, free fatty acids (FFA), and insulin [2], [3]; and the combination of HF and T2D induces complex metabolic changes in the myocardium [4]. It is a matter of debate whether these abnormalities [3], [5], [6] are causally involved in the progression of HF or merely epiphenomenal [7], [8].…”

Section: Introductionmentioning

confidence: 99%

Effect of Acute Hyperglycemia on Left Ventricular Contractile Function in Diabetic Patients with and without Heart Failure: Two Randomized Cross-Over Studies

Nielsen¹,

Nørrelund²,

Kampmann³

et al. 2013

PLoS ONE

Self Cite

View full text Add to dashboard Cite

BackgroundIt is unknown whether changes in circulating glucose levels due to short-term insulin discontinuation affect left ventricular contractile function in type 2 diabetic patients with (T2D-HF) and without (T2D-nonHF) heart failure.Materials and MethodsIn two randomized cross-over-designed trials, 18 insulin-treated type 2 diabetic patients with (Ejection Fraction (EF) 36±6%, n = 10) (trial 2) and without systolic heart failure (EF 60±3%, n = 8) (trial 1) were subjected to hyper- and normoglycemia for 9–12 hours on two different occasions. Advanced echocardiography, bicycle exercise tests and 6-minute hall walk distance were applied.ResultsPlasma glucose levels differed between study arms (6.5±0.8 mM vs 14.1±2.6 mM (T2D-HF), 5.8±0.4 mM vs 9.9±2.1 mM (T2D-nonHF), p<0.001). Hyperglycemia was associated with an increase in several parameters: maximal global systolic tissue velocity (Vmax) (p<0.001), maximal mitral annulus velocity (S'max) (p<0.001), strain rate (p = 0.02) and strain (p = 0.05). Indices of increased myocardial systolic contractile function were significant in both T2D-HF (Vmax: 14%, p = 0.02; S'max: 10%, p = 0.04), T2D-nonHF (Vmax: 12%, p<0.01; S'max: 9%, p<0.001) and in post exercise S'max (7%, p = 0.049) during hyperglycemia as opposed to normoglycemia. LVEF did not differ between normo- and hyperglycemia (p = 0.17), and neither did peak exercise capacity nor catecholamine levels. Type 2 diabetic heart failure patients' 6-minute hall walk distance improved by 7% (p = 0.02) during hyperglycemia as compared with normoglycemia.ConclusionsShort-term hyperglycemia by insulin discontinuation is associated with an increase in myocardial systolic contractile function in type 2 diabetic patients with and without heart failure and with a slightly prolonged walking distance in type 2 diabetic heart failure patients. (Clinicaltrials.gov identifier NCT00653510)

show abstract

Section: Introductionmentioning

confidence: 99%

Effect of Acute Hyperglycemia on Left Ventricular Contractile Function in Diabetic Patients with and without Heart Failure: Two Randomized Cross-Over Studies

Nielsen¹,

Nørrelund²,

Kampmann³

et al. 2013

PLoS ONE

Self Cite

View full text Add to dashboard Cite

show abstract

“…Reduced insulin signaling also inhibits glucose utilization by regulating the role of enzymes in the glycolysis pathway, such as hexokinase and phosphofructokinase 2 [88,89]. Declines in myocardial glucose uptake and utilization have also been observed in patients with diabetes [90].…”

Section: Insulin Resistance and Cardiac Energy Metabolismmentioning

confidence: 99%

Effects of Lipid Overload on Heart in Metabolic Diseases

Xie

Ding

et al. 2021

Horm Metab Res

View full text Add to dashboard Cite

Metabolic diseases are often associated with lipid and glucose metabolism abnormalities, which increase the risk of cardiovascular disease. Diabetic cardiomyopathy (DCM) is an important development of metabolic diseases and a major cause of death. Lipids are the main fuel for energy metabolism in the heart. The increase of circulating lipids affects the uptake and utilization of fatty acids and glucose in the heart, and also affects mitochondrial function. In this paper, the mechanism of lipid overload in metabolic diseases leading to cardiac energy metabolism disorder is discussed.

show abstract

“…They demonstrated decreased myocardial glucose utilization and reduced extraction of glucose and suggested that myocardial insulin resistance in these patients may explain their poor long-term outcome. Søndergaard et al (98) studied 27 diabetic patients with CAD and normal left ventricular function to determine whether myocardial insulin resistance was present, as it is in patients with CAD, diabetes, and abnormal left ventricular function. They were unable to demonstrate insulin resistance using PET-FDG.…”

Section: Ventricular Functionmentioning

confidence: 99%

The Year in Cardiac Imaging

Gibbons

Araoz

Williamson

2007

Journal of the American College of Cardiology

View full text Add to dashboard Cite

This review is a sequel to our previous reports highlighting the most important recent literature in single-photon emission computed tomography (SPECT) myocardial perfusion imaging, cardiac positron emission tomography (PET), cardiac computed tomography (CT), and cardiac magnetic resonance imaging (MRI). In almost all cases, these studies were published in the English-language literature between April 1, 2006, and March 31, 2007. The decision to arbitrarily include some articles and exclude others is more difficult each year. Time has exposed some of our previous errors. Last year, we did not include the first case report on nephrogenic systemic fibrosis. This year, we added a whole new safety section on this topic. We can assure both authors and readers that we have done our best to put aside personal biases in reaching these difficult decisions. We have again organized this summary around topical themes in an effort to encourage a broad, multimodality approach to the application of imaging to clinical problems. Technical AdvancesPET. Although cardiac F-18 fluorodeoxyglucose (FDG)-PET imaging is a well-established technique, vascular FDG-PET imaging is not. Two studies addressed this emerging area. Tawakol et al. (1) compared the results of FDG-PET imaging with tissue samples obtained during subsequent carotid endarterectomy to demonstrate a significant correlation between FDG uptake and both carotid plaque and macrophage staining. This early study offers great promise if subsequent studies demonstrate that increased carotid FDG activity predicts subsequent cerebrovascular events. Tahara et al. (2) used FDG-PET vascular imaging in a randomized trial of 43 patients to demonstrate a decrease in FDG uptake in patients treated with simvastatin. CT. The rapid technical advances in CT continue. Early studies described the use of 256-row cone beam and dual-source CT, both introduced in last year's review. Using dual-source CT, Johnson et al. (3) demonstrated impressive temporal resolution and robust coronary artery imaging at a wide range of heart rates. Scheffel et al. ( 4) showed similar results, with excellent negative predictive value for Ͼ50% stenosis despite a lack of beta-blockade. MRI. Advances in MRI software and computer processing have lead to faster, more robust performance. There is a small-but-growing literature in which MRI acquisitions are acquired in a single breath hold, or in a free-breathing state. Attempts to decrease the breathing requirements for MRI volume measurements are summarized in Table 1 (5-10). The ability to perform MRI acquisitions in a single breath hold, or in a free-breathing state, would substantially reduce the main limitation of MRI (i.e., the level of required patient cooperation). Viability PET.Previous studies have reported conflicting data on the duration of survival of hibernating myocardium. Wiggers et al. (11) performed serial sestamibi SPECT and FDG-PET on 16 patients with chronically stunned or hibernating myocardium who were treated with medical therapy for approximatel...

show abstract

Impact of Type 2 Diabetes on Myocardial Insulin Sensitivity to Glucose Uptake and Perfusion in Patients with Coronary Artery Disease

Abstract: Myocardial IR to glucose uptake is not an inherent feature in T2DM patients with preserved LVEF. Acute physiological insulin exposure exerts no coronary vasodilation in CAD patients irrespective of T2DM.

Cited by 12 publications

References 28 publications

Effect of Acute Hyperglycemia on Left Ventricular Contractile Function in Diabetic Patients with and without Heart Failure: Two Randomized Cross-Over Studies

Effect of Acute Hyperglycemia on Left Ventricular Contractile Function in Diabetic Patients with and without Heart Failure: Two Randomized Cross-Over Studies

Effects of Lipid Overload on Heart in Metabolic Diseases

The Year in Cardiac Imaging

Contact Info

Product

Resources

About