Preoperative glutamine infusion improves glycemia in heart surgery patients

Hissa, Miguel Nasser; Vasconcelos, Renata dos Santos; Guimarães, Sérgio Botelho; Silva, Ricardo Pereira; Garcia, José Huygens Parente; Vasconcelos, Paulo Roberto Leitão de

doi:10.1590/s0102-86502011000700016

Cited by 9 publications

(4 citation statements)

References 16 publications

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“…Acute oral administration of Gln improves glucose tolerance in subjects with or without diabetes, while chronic dietary supplementation of Gln for 6 weeks reduces systolic blood pressure, fasting blood glucose, and improves body composition in patients with type 2 diabetes [28,29]. In addition, Gln administration decreases glycemia in adolescents with type 1 diabetes and in patients undergoing myocardial revascularization [30,31]. Parenteral administration of Gln also prevents the decrease in insulin sensitivity in multiple-trauma patients [32].…”

Section: L-glutamine and Cardiometabolic Diseasementioning

confidence: 99%

The Emerging Role of l-Glutamine in Cardiovascular Health and Disease

Durante

2019

Nutrients

113

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Emerging evidence indicates that l-glutamine (Gln) plays a fundamental role in cardiovascular physiology and pathology. By serving as a substrate for the synthesis of DNA, ATP, proteins, and lipids, Gln drives critical processes in vascular cells, including proliferation, migration, apoptosis, senescence, and extracellular matrix deposition. Furthermore, Gln exerts potent antioxidant and anti-inflammatory effects in the circulation by inducing the expression of heme oxygenase-1, heat shock proteins, and glutathione. Gln also promotes cardiovascular health by serving as an l-arginine precursor to optimize nitric oxide synthesis. Importantly, Gln mitigates numerous risk factors for cardiovascular disease, such as hypertension, hyperlipidemia, glucose intolerance, obesity, and diabetes. Many studies demonstrate that Gln supplementation protects against cardiometabolic disease, ischemia-reperfusion injury, sickle cell disease, cardiac injury by inimical stimuli, and may be beneficial in patients with heart failure. However, excessive shunting of Gln to the Krebs cycle can precipitate aberrant angiogenic responses and the development of pulmonary arterial hypertension. In these instances, therapeutic targeting of the enzymes involved in glutaminolysis such as glutaminase-1, Gln synthetase, glutamate dehydrogenase, and amino acid transaminase has shown promise in preclinical models. Future translation studies employing Gln delivery approaches and/or glutaminolysis inhibitors will determine the success of targeting Gln in cardiovascular disease.

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Section: L-glutamine and Cardiometabolic Diseasementioning

confidence: 99%

The Emerging Role of l-Glutamine in Cardiovascular Health and Disease

Durante

2019

Nutrients

113

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“…35,36 Inclusion of aspartate, glutamate and glutamine in animal heart perfusates and cardioplegic solutions improves metabolic and functional recovery and elevates high-energy phosphate levels postischemia, and they have been used experimentally in cardioplegic solutions with good results. 17,18,27,40 Questions regarding the efficacy of these amino acids may arise from xenotypic differences, protocol incompatibility or the use of free acids versus amino acid salts. 35 Another assumption is that perfused amino acids are readily available for intracellular functions, without regard to transporter activity.…”

Section: Tryptophanmentioning

confidence: 99%

Amino acids as metabolic substrates during cardiac ischemia

Drake

Sidorov

McGuinness

et al. 2012

Exp Biol Med (Maywood)

113

104

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The heart is well known as a metabolic omnivore in that it is capable of consuming fatty acids, glucose, ketone bodies, pyruvate, lactate, amino acids and even its own constituent proteins, in order of decreasing preference. The energy from these substrates supports not only mechanical contraction, but also the various transmembrane pumps and transporters required for ionic homeostasis, electrical activity, metabolism and catabolism. Cardiac ischemia – for example, due to compromise of the coronary vasculature or end-stage heart failure – will alter both electrical and metabolic activity. While the effects of myocardial ischemia on electrical propagation and stability have been studied in depth, the effects of ischemia on metabolic substrate preference has not been fully appreciated: oxygen deprivation during ischemia will significantly alter the relative ability of the heart to utilize each of these substrates. Although changes in cardiac metabolism are understood to be an underlying component in almost all cardiac myopathies, the potential contribution of amino acids in maintaining cardiac electrical conductance and stability during ischemia is underappreciated. Despite clear evidence that amino acids exert cardioprotective effects in ischemia and other cardiac disorders, their role in the metabolism of the ischemic heart has yet to be fully elucidated. This review synthesizes the current literature of the metabolic contribution of amino acids during ischemia by analyzing relevant historical and recent research.

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“…Previous experimental studies have demonstrated that GLN had favorable effects against IR injury. The studies found that pretreatment with GLN reduced oxidative stress and enhanced cell survival locally 16 ‐ 18 and had a protective effect against organ injury following IR 19 , 20 . However, these studies provided GLN before tissue ischemia.…”

Section: Introductionmentioning

confidence: 99%