Insulin improves myocardial blood flow in patients with type 2 diabetes and coronary artery disease.
نویسندگان
چکیده
Insulin infusion improves myocardial blood flow (MBF) in healthy subjects. Until now, the effect of insulin on myocardial perfusion in type 2 diabetic subjects with coronary artery disease (CAD) has been unknown. We studied the effects of insulin on MBF in ischemic regions evaluated by single-photon emission-computed tomography and coronary angiography and in nonischemic regions in 43 subjects (ages 63 +/- 7 years) with type 2 diabetes (HbA(1c) 7.1 +/- 0.9%). MBF was measured at fasting and during a euglycemic-hyperinsulinemic clamp at rest (n = 43) and during adenosine-induced (140 mug . kg(-1) . min(-1) for 7 min) hyperemia (n = 26) using positron emission tomography and (15)O-labeled water. MBF was significantly attenuated in ischemic regions as compared with in nonischemic regions (P < 0.0001) and was increased by insulin as compared with in the fasting state (P < 0.0001). At rest, insulin infusion increased MBF by 13% in ischemic regions (P = 0.043) and 22% in nonischemic regions (P = 0.003). During adenosine infusion, insulin enhanced MBF by 20% (P = 0.018) in ischemic regions and 18% (P = 0.045) in nonischemic regions. In conclusion, insulin infusion improved MBF similarly in ischemic and nonischemic regions in type 2 diabetic subjects with CAD. Consequently, in addition to its metabolic effects, insulin infusion may improve endothelial function and thus increase the threshold for ischemia and partly contribute to the beneficial effects found in clinical trials in these subjects.
منابع مشابه
Myocardial blood flow in patients withType 2 Diabetes Mellitus and normal coronary angiography
Introduction Type 2 Diabetes Mellitus (T2DM) is associated with an increased risk of heart failure independently of underlying coronary artery disease (CAD) [1]. Myocardial blood flow (MBF) and MBF reserve can be abnormal in patients with T2DM due to myocardial microvascular dysfunction, contributing to the development of heart failure [2]. The myocardial layers may be affected differently by t...
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ورودعنوان ژورنال:
- Diabetes
دوره 55 2 شماره
صفحات -
تاریخ انتشار 2006