Abstract
An Experimental Series Investigating the Effects of Euglycaemic Hyperinsulinaemia on Myocardial Blood Flow Reserve in Healthy Individuals and Perfusion Defect Size in Patients Presenting With Acute Myocardial Infarction
Heart, Lung and Circulation, Vol.27(Supplement 2), pp.S298-S299
Cardiac Society of Australia and New Zealand Annual Scientific Meeting, the International Society for Heart Research Australasian Section Annual Scientific Meeting and the 12th Annual Australia and New Zealand Endovascular Therapies Meeting, 66th (Brisbane, Australia, 02-Aug-2018 - 05-Aug-2018)
2018
Abstract
Background: Euglycaemic hyperinsulinaemia increases myocardial blood flow reserve (MBFR) and may reduce myocardial ischaemia. Using insulin-dextrose infusions, a two-phase study was conducted to determine: 1) how insulin duration, dose, and diabetes affect MBFR response; 2) the effect of insulin-dextrose on perfusion in the immediate period following revascularisation of ST-elevation myocardial infarction (STEMI). Methods: MBFR was determined using vasodilator myocardial contrast echocardiography (MCE). Twelve participants received insulin-dextrose or saline infusion. MBFR was measured at four time-points. Twenty-two received one of three insulin doses (0.5, 1.5, 3.0 mU/kg/minute), and 11 insulin-resistant participants (five metabolic syndrome, six type-2 diabetes) received 1.5 mU/kg/minute for 60 minutes. Baseline and 60-minute MBFRs were determined. Immediately following revascularisation for STEMI, 20 participants received 1.5 mU/kg/minute insulin-dextrose infusion or standard care for 120 minutes. MCE was performed at four time points to quantify percentage contrast defect length over total left ventricular endocardial border (CDL). Results: Insulin duration: MBFR increased with time in the insulin-dextrose group. Insulin dose: from baseline, MBFR increased in the 1.5 mU/kg/minute (2.42±0.39 to 3.25±0.77, p = 0.002), did not change in 0.5 mU/kg/minute, and decreased in 3.0 mU/kg/minute (2.64±0.25 to 2.16±0.33, p = 0.02) groups. Diabetes: from baseline, MBFR increased in healthy and metabolic syndrome (1.98±0.33 to 2.59±0.45, p = 0.04), but was borderline significant in diabetes (1.67±0.35 to 2.14±0.21, p = 0.05). STEMI: Baseline CDL was similar in both groups. It decreased with time and was significantly lower at 60 minutes with insulin-dextrose. Conclusion: Insulin infusion duration, dose, and diabetes are important factors that affect MBFR. When given after revascularisation for STEMI, insulin-dextrose reduces CDL.
Details
- Title
- An Experimental Series Investigating the Effects of Euglycaemic Hyperinsulinaemia on Myocardial Blood Flow Reserve in Healthy Individuals and Perfusion Defect Size in Patients Presenting With Acute Myocardial Infarction
- Authors
- Michael C Y Nam (Author) - Sunshine Coast University HospitalAnnelise L Meneses (Author) - University of the Sunshine Coast - Faculty of Science, Health, Education and EngineeringC Anstey (Author) - Sunshine Coast University HospitalChristopher D Askew (Author) - University of the Sunshine Coast - Faculty of Science, Health, Education and EngineeringI Hickman (Author) - University of QueenslandTom G Bailey (Author) - University of QueenslandJ Quah (Author) - Sunshine Coast University HospitalR Senior (Author) - Imperial College London, United KingdomS Cox (Author) - Sunshine Coast University HospitalR Poulter (Author) - Sunshine Coast University HospitalS Butterly (Author) - Sunshine Coast University HospitalM Fryer (Author) - Sunshine Coast University HospitalA Russell (Author) - University of QueenslandTony Stanton (Author) - Sunshine Coast Hospital and Health ServiceKim Greaves (Author) - University of the Sunshine Coast - Faculty of Science, Health, Education and Engineering
- Publication details
- Heart, Lung and Circulation, Vol.27(Supplement 2), pp.S298-S299
- Conference details
- Cardiac Society of Australia and New Zealand Annual Scientific Meeting, the International Society for Heart Research Australasian Section Annual Scientific Meeting and the 12th Annual Australia and New Zealand Endovascular Therapies Meeting, 66th (Brisbane, Australia, 02-Aug-2018 - 05-Aug-2018)
- Publisher
- Elsevier Australia
- DOI
- 10.1016/j.hlc.2018.06.570
- ISSN
- 1443-9506
- Organisation Unit
- UniSC Clinical Trials Centre; School of Health and Sport Sciences - Legacy; School of Health and Behavioural Sciences - Legacy; University of the Sunshine Coast, Queensland; Faculty of Science, Health, Education and Engineering; School of Health - Sports & Exercise Science
- Language
- English
- Record Identifier
- 99451154602621
- Output Type
- Abstract
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