Abnormal Glucose Tolerance Is Associated with a Reduced Myocardial Metabolic Flexibility in Patients with Dilated Cardiomyopathy
Dilated cardiomyopathy (DCM) is characterized by a metabolic shift from fat to carbohydrates and failure to increase myocardial glucose uptake in response to workload increments. We verified whether this pattern is influenced by an abnormal glucose tolerance (AGT). In 10 patients with DCM, 5 with no...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Journal of Diabetes Research |
| Online Access: | http://dx.doi.org/10.1155/2016/3906425 |
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| author | Domenico Tricò Simona Baldi Silvia Frascerra Elena Venturi Paolo Marraccini Danilo Neglia Andrea Natali |
| author_facet | Domenico Tricò Simona Baldi Silvia Frascerra Elena Venturi Paolo Marraccini Danilo Neglia Andrea Natali |
| author_sort | Domenico Tricò |
| collection | DOAJ |
| description | Dilated cardiomyopathy (DCM) is characterized by a metabolic shift from fat to carbohydrates and failure to increase myocardial glucose uptake in response to workload increments. We verified whether this pattern is influenced by an abnormal glucose tolerance (AGT). In 10 patients with DCM, 5 with normal glucose tolerance (DCM-NGT) and 5 with AGT (DCM-AGT), and 5 non-DCM subjects with AGT (N-AGT), we measured coronary blood flow and arteriovenous differences of oxygen and metabolites during Rest, Pacing (at 130 b/min), and Recovery. Myocardial lactate exchange and oleate oxidation were also measured. At Rest, DCM patients showed a reduced nonesterified fatty acids (NEFA) myocardial uptake, while glucose utilization increased only in DCM-AGT. In response to Pacing, glucose uptake promptly rose in N-AGT (from 72 ± 21 to 234 ± 73 nmol/min/g, p<0.05), did not change in DCM-AGT, and slowly increased in DCM-NGT. DCM-AGT sustained the extra workload by increasing NEFA oxidation (from 1.3 ± 0.2 to 2.9 ± 0.1 μmol/min/gO2 equivalents, p<0.05), while DCM-NGT showed a delayed increase in glucose uptake. Substrate oxidation rates paralleled the metabolites data. The presence of AGT in patients with DCM exacerbates both the shift from fat to carbohydrates in resting myocardial metabolism and the reduced myocardial metabolic flexibility in response to an increased workload. This trial is registered with ClinicalTrial.gov NCT02440217. |
| format | Article |
| id | doaj-art-8b3321cb44654c2b920174865663c9a0 |
| institution | Kabale University |
| issn | 2314-6745 2314-6753 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes Research |
| spelling | doaj-art-8b3321cb44654c2b920174865663c9a02025-02-03T01:02:50ZengWileyJournal of Diabetes Research2314-67452314-67532016-01-01201610.1155/2016/39064253906425Abnormal Glucose Tolerance Is Associated with a Reduced Myocardial Metabolic Flexibility in Patients with Dilated CardiomyopathyDomenico Tricò0Simona Baldi1Silvia Frascerra2Elena Venturi3Paolo Marraccini4Danilo Neglia5Andrea Natali6Dipartimento di Medicina Clinica e Sperimentale, Via Roma 67, 56126 Pisa, ItalyDipartimento di Medicina Clinica e Sperimentale, Via Roma 67, 56126 Pisa, ItalyDipartimento di Medicina Clinica e Sperimentale, Via Roma 67, 56126 Pisa, ItalyDipartimento di Medicina Clinica e Sperimentale, Via Roma 67, 56126 Pisa, ItalyNational Research Council, Institute of Clinical Physiology, Pisa, ItalyNational Research Council, Institute of Clinical Physiology, Pisa, ItalyDipartimento di Medicina Clinica e Sperimentale, Via Roma 67, 56126 Pisa, ItalyDilated cardiomyopathy (DCM) is characterized by a metabolic shift from fat to carbohydrates and failure to increase myocardial glucose uptake in response to workload increments. We verified whether this pattern is influenced by an abnormal glucose tolerance (AGT). In 10 patients with DCM, 5 with normal glucose tolerance (DCM-NGT) and 5 with AGT (DCM-AGT), and 5 non-DCM subjects with AGT (N-AGT), we measured coronary blood flow and arteriovenous differences of oxygen and metabolites during Rest, Pacing (at 130 b/min), and Recovery. Myocardial lactate exchange and oleate oxidation were also measured. At Rest, DCM patients showed a reduced nonesterified fatty acids (NEFA) myocardial uptake, while glucose utilization increased only in DCM-AGT. In response to Pacing, glucose uptake promptly rose in N-AGT (from 72 ± 21 to 234 ± 73 nmol/min/g, p<0.05), did not change in DCM-AGT, and slowly increased in DCM-NGT. DCM-AGT sustained the extra workload by increasing NEFA oxidation (from 1.3 ± 0.2 to 2.9 ± 0.1 μmol/min/gO2 equivalents, p<0.05), while DCM-NGT showed a delayed increase in glucose uptake. Substrate oxidation rates paralleled the metabolites data. The presence of AGT in patients with DCM exacerbates both the shift from fat to carbohydrates in resting myocardial metabolism and the reduced myocardial metabolic flexibility in response to an increased workload. This trial is registered with ClinicalTrial.gov NCT02440217.http://dx.doi.org/10.1155/2016/3906425 |
| spellingShingle | Domenico Tricò Simona Baldi Silvia Frascerra Elena Venturi Paolo Marraccini Danilo Neglia Andrea Natali Abnormal Glucose Tolerance Is Associated with a Reduced Myocardial Metabolic Flexibility in Patients with Dilated Cardiomyopathy Journal of Diabetes Research |
| title | Abnormal Glucose Tolerance Is Associated with a Reduced Myocardial Metabolic Flexibility in Patients with Dilated Cardiomyopathy |
| title_full | Abnormal Glucose Tolerance Is Associated with a Reduced Myocardial Metabolic Flexibility in Patients with Dilated Cardiomyopathy |
| title_fullStr | Abnormal Glucose Tolerance Is Associated with a Reduced Myocardial Metabolic Flexibility in Patients with Dilated Cardiomyopathy |
| title_full_unstemmed | Abnormal Glucose Tolerance Is Associated with a Reduced Myocardial Metabolic Flexibility in Patients with Dilated Cardiomyopathy |
| title_short | Abnormal Glucose Tolerance Is Associated with a Reduced Myocardial Metabolic Flexibility in Patients with Dilated Cardiomyopathy |
| title_sort | abnormal glucose tolerance is associated with a reduced myocardial metabolic flexibility in patients with dilated cardiomyopathy |
| url | http://dx.doi.org/10.1155/2016/3906425 |
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