Diabetes abolishes ischemic preconditioning: role of glucose, insulin, and osmolality
Diabetes abolishes ischemic preconditioning: role of glucose, insulin, and osmolality
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DOI：
10.1152/ajpheart.2000.278.4.h1218
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发表时间：
2000-04-01
影响因子：
4.8
通讯作者：
Warltier, DC
中科院分区：
文献类型：
--
作者：
Kersten, JR;Toller, WG;Warltier, DC
最近的证据表明，高血糖是心血管疾病发展的一个重要危险因素。我们在糖尿病和急性高血糖的犬模型中验证了心肌梗死面积与血糖浓度有关的假设，无论有无缺血预处理（PC）刺激。巴比妥麻醉犬冠状动脉闭塞60分钟，再灌注3小时。在对照犬中，梗死面积为梗死危险面积（AAR）的24 +/- 2%。PC显著（P < 0.05）降低了正常犬（8 +/- 2%的AAR）的梗死范围，而对糖尿病犬（22 +/- 4%的AAR）无显著影响。急性高血糖期间（r = 0.96, P < 0.001）和糖尿病期间（r = 0.74, P < 0.002），在存在或不存在PC刺激时，梗死面积与血糖浓度呈线性相关。棉子糖（300 g）引起的血清渗透压升高不会增加梗死面积（11% /- 3%的AAR）或干扰PC保护梗死的能力（2% /- 1%的AAR）。结果表明，高血糖是狗心肌梗死程度的主要决定因素。
Recent evidence indicates that hyperglycemia is an important risk factor for the development of cardiovascular disease. We tested the hypothesis that myocardial infarct size is related to blood glucose concentration in the presence or absence of ischemic preconditioning (PC) stimuli in canine models of diabetes mellitus and acute hyperglycemia. Barbiturate-anesthetized dogs were subjected to a 60-min period of coronary artery occlusion and 3-h reperfusion. Infarct size was 24 +/- 2% of the area at risk (AAR) for infarction in control dogs. PC significantly (P < 0.05) decreased the extent of infarction in normal(8 +/- 2% of AAR), but not diabetic (22 +/- 4% of AAR), dogs. Infarct size was linearly related to blood glucose concentration during acute hyperglycemia (r = 0.96; P < 0.001) and during diabetes (r = 0.74; P < 0.002) in the presence or absence of PC stimuli. Increases in serum osmolality caused by administration of raffinose (300 g) did not increase infarct size (11 +/- 3% of AAR) or interfere with the ability of PC to protect against infarction (2 +/- 1% of AAR). The results indicate that hyperglycemia is a major determinant of the extent of myocardial infarction in the dog.