Glucose uptake in the chronically dysfunctional but viable myocardium
Glucose uptake in the chronically dysfunctional but viable myocardium
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DOI：
10.1161/01.cir.93.9.1658
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发表时间：
1996-05-01
期刊：
影响因子：
37.8
通讯作者：
Knuuti, J
中科院分区：
文献类型：
--
作者：
Maki, M;Luotolahti, M;Knuuti, J
背景的葡萄糖摄取的调节功能障碍，但可行的心肌还没有被研究以前在human.Methods和结果7例患者闭塞的主要冠状动脉，但没有以前的梗死进行了研究，两次与2-[F-18]氟-2-脱氧-D-葡萄糖正电子发射断层扫描，一次在空腹状态，一次在高胰岛素正常血糖钳夹。用[O-15]H2O测定心肌血流量。显示稳定室壁运动异常的闭塞动脉以外的心肌区域代表慢性功能障碍但有活力的组织。其中6例患者后来接受了血运重建，在相应区域检测到室壁运动恢复，这证实了生存能力。在功能障碍心肌中检测到的心肌血流量略低于远端心肌区域（0.81+/-0.27 vs 1.02+/-0.23 mL）。g（-1）。min（-1），P=.036）。在空腹状态下，与正常心肌相比，功能障碍区域的葡萄糖摄取略有增加（15+/-10 vs. 11+/-10 μ mol/100 g/min，P= 0.038）。在胰岛素阻断期间，在功能障碍区和正常区，胰岛素对葡萄糖的摄取均显著增加（分别为72+/-22和79+/-21 μ mol/100 g/min; P
Background The regulation of glucose uptake in the dysfunctional but viable myocardium has not been studied previously in humans.Methods and Results Seven patients with an occluded major coronary artery but no previous infarction were studied twice with 2-[F-18]fluoro-2-deoxy-D-glucose positron emission tomography, once in the fasting state and once during hyperinsulinemic euglycemic clamping. Myocardial blood flow was measured with [O-15]H2O. The myocardial region beyond an occluded artery that showed stable wall-motion abnormality represented chronically dysfunctional but viable tissue. Six of the patients were later revascularized, and wall-motion recovery was detected in the corresponding regions, which confirmed viability. A slightly reduced myocardial blood flow was detected in the dysfunctional than in the remote myocardial regions (0.81+/-0.27 versus 1.02+/-0.23 mL . g(-1). min(-1), P=.036). In the fasting state, glucose uptake was slightly increased in the dysfunctional regions compared with normal myocardium (15+/-10 versus 11+/-10 mu mol/100 g per minute, P=.038). During insulin clamping, a striking increase in glucose uptake by insulin was obtained in both the dysfunctional and the normal regions (72+/-22 and 79+/-21 mu mol/100 g per minute, respectively; P