Low whole-body insulin sensitivity in patients with ischaemic heart disease is associated with impaired myocardial glucose uptake predictive of poor ... View Full Text


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Article Info

DATE

2002-08

AUTHORS

Klaus F. Kofoed, Steen Carstensen, Jens D. Hove, Jacob Freiberg, Regitze Bangsgaard, Søren Holm, Alan Rabøl, Birger Hesse, Henrik Arendrup, Henning Kelbæk

ABSTRACT

We tested the hypothesis that low whole-body insulin sensitivity in patients with ischaemic heart disease and impaired left ventricular (LV) function is associated with abnormalities of insulin-mediated myocardial glucose uptake affecting outcome after coronary bypass surgery (CABG). We studied 29 patients with ischaemic heart disease and impaired LV ejection fraction (EF) and age-matched healthy volunteers ( n = 30). As assessed by euglycaemic glucose-insulin clamp, 15 patients had a low and 14 a normal whole-body insulin sensitivity. Using positron emission tomography, patterns of fluorine-18 fluorodeoxyglucose and nitrogen-13 ammonia uptake in addition to quantified glucose uptake, blood flow and hyperaemic blood flow were assessed before CABG in 16 myocardial segments of the left ventricle. Major adverse cardiac events and LVEF were evaluated 7 months after CABG. Glucose uptake in normokinetic PET-normal myocardium was found to be higher in patients with normal whole-body insulin sensitivity ( P < 0.001), whereas in patients with low whole-body insulin sensitivity more segments displayed a pattern of reduced glucose uptake in normoperfused myocardium (PET-reverse mismatch) ( P < 0.05). Hyperaemic blood flow was impaired in both patient groups. A major cardiac event after CABG could partly be predicted by the LV extent of normoperfused segments with PET-reverse mismatch. We conclude that low whole-body insulin sensitivity in patients with ischaemic heart disease and impaired LV function is associated with impaired insulin-mediated myocardial glucose uptake, which is partially predictive of a worse outcome after CABG. More... »

PAGES

991-998

References to SciGraph publications

  • 1998-06. Fluorodeoxyglucose uptake in dysfunctional myocardium subtended by an occluded coronary artery in THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING
  • 2001-04. PET reversed mismatch in an experimental model of subacute myocardial infarction in EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
  • 2001-04. PET "reversed mismatch pattern" early after acute myocardial infarction: follow-up of flow, metabolism and function in EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00259-002-0827-0

    DOI

    http://dx.doi.org/10.1007/s00259-002-0827-0

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1003538953

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/12173011


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