Acute hyperglycemia reduces myocardial blood flow reserve and the magnitude of reduction is associated with insulin resistance: A study in nondiabetic humans using contrast echocardiography

Sahar S. Abdelmoneim, Mary E. Hagen, Edward Mendrick, Vishwanath Pattan, Benjamin Wong, Barbara Norby, Tamara Roberson, Troy Szydel, Rita Basu, Ananda Basu, Sharon L. Mulvagh

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

The effect of acute hyperglycemia per se on coronary perfusion in humans is undefined. We evaluated the effects of short-term hyperglycemia on myocardial blood flow reserve (MBFR) in healthy nondiabetic volunteers. Twenty-one nondiabetic volunteers (76 % females, mean ± SD, age 48 ± 5 years) had noninvasive MBFR assessment while exposed to pancreatic clamp with somatostatin and replacement glucagon and growth hormone infusions, with frequent interval plasma glucose (PG) monitoring. Insulin was infused at 0.75 mU/kg/min to mimic postprandial plasma insulin concentrations, and glucose was infused to maintain euglycemia (PG 93.9 ± 7.3 mg/dl) followed by hyperglycemia (PG 231.5 ± 18.1 mg/dl). Myocardial contrast echocardiography (MCE) was performed during each glycemic steady state using continuous infusion of Definity at rest and during regadenoson (Lexiscan 5 ml (400 μg) intravenous bolus) infusion to quantify myocardial blood flow (MBF) and determine MBFR. Insulin resistance (IR) was assessed by glucose infusion rate (GIR; mg/kg/min) at euglycemia. Median stress MBF, MBFR, and β reserve were significantly reduced during acute hyperglycemia versus euglycemia (stress MBF 3.9 vs 5.4, P = 0.02; MBFR 2.0 vs 2.7, P < 0.0001; β reserve 1.45 vs 2.4, P = 0.007). Using a median threshold GIR of 5 mg/kg/min, there was a correlation between GIR and hyperglycemic MBFR (r = 0.506, P = 0.019). MBFR, as determined noninvasively by MCE, is significantly decreased during acute hyperglycemia in nondiabetic volunteers, and the magnitude of this reduction is modulated by IR.

Original languageEnglish (US)
Pages (from-to)757-768
Number of pages12
JournalHeart and vessels
Volume28
Issue number6
DOIs
StatePublished - Nov 2013

Keywords

  • Insulin resistance
  • Myocardial blood flow reserve
  • Myocardial perfusion contrast echocardiography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Abdelmoneim, S. S., Hagen, M. E., Mendrick, E., Pattan, V., Wong, B., Norby, B., Roberson, T., Szydel, T., Basu, R., Basu, A., & Mulvagh, S. L. (2013). Acute hyperglycemia reduces myocardial blood flow reserve and the magnitude of reduction is associated with insulin resistance: A study in nondiabetic humans using contrast echocardiography. Heart and vessels, 28(6), 757-768. https://doi.org/10.1007/s00380-012-0305-y