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2.
Am J Physiol Heart Circ Physiol ; 281(3): H1131-6, 2001 Sep.
Article in English | MEDLINE | ID: mdl-11514279

ABSTRACT

The present study was designed to determine whether myocardial atrophy is necessarily associated with changes in cardiac contractility. Myocardial unloading of normal hearts was produced via heterotopic transplantation in rats. Contractions of isolated myocytes (1.2 mM Ca2+; 37 degrees C) were assessed during field stimulation (0.5, 1.0, and 2.0 Hz), and papillary muscle contractions were assessed during direct stimulation (2.0 mM Ca2+; 37 degrees C; 0.5 Hz). Hemodynamic unloading was associated with a 41% decrease in median myocyte volume and proportional decreases in myocyte length and width. Nevertheless, atrophic myocytes had normal fractional shortening, time to peak contraction, and relaxation times. Despite decreases in absolute maximal force generation (F(max)), there were no differences in F(max)/ area in papillary muscles isolated from unloaded transplanted hearts. Therefore, atrophic remodeling after unloading is associated with intact contractile function in isolated myocytes and papillary muscles when contractile indexes are normalized to account for reductions in cell length and cross-sectional area, respectively. Nevertheless, in the absence of compensatory increases in contractile function, reductions in myocardial mass will lead to impaired overall work capacity.


Subject(s)
Atrophy/physiopathology , Heart/physiopathology , Myocardial Contraction , Ventricular Remodeling , Animals , Aorta, Abdominal/physiology , Aorta, Abdominal/surgery , Body Weight , Cell Separation , Electric Stimulation , Heart Transplantation/methods , In Vitro Techniques , Male , Myocardium/pathology , Organ Size , Papillary Muscles/physiopathology , Rats , Rats, Inbred Lew , Vena Cava, Inferior/physiology , Vena Cava, Inferior/surgery
3.
Circulation ; 103(13): 1734-9, 2001 Apr 03.
Article in English | MEDLINE | ID: mdl-11282903

ABSTRACT

BACKGROUND: Patients with non-insulin-dependent diabetes mellitus (NIDDM) exhibit poor clinical outcomes from myocardial ischemia. This may reflect an impairment in their cardiac insulin-response system. METHODS AND RESULTS: We used AV balance and intracoronary infusion techniques to compare the intrinsic cardiac responsiveness to insulin in 26 coronary disease patients with (n=13) and without (n=13) NIDDM. During fasting, NIDDM hearts demonstrated lower fractional extraction of glucose from arterial plasma than controls (1.0+/-0.5% versus 2.1+/-0.5%, P<0.05) despite higher circulating insulin levels (26+/-5 versus 13+/-4 microU. mL, P<0.05). This was compensated for by higher circulating glucose levels, so that net cardiac glucose uptake in the 2 groups was equivalent (5.2+/-1.1 versus 5.3+/-1.1 micromol. min). Intracoronary insulin infusion produced an approximately 3-fold increase in fractional extraction and net uptake of glucose across the heart in both groups (to 3.7+/-0.4% and 18.3+/-3.5 micromol. min in NIDDM and to 5.4+/-0.7% and 17.7+/-4.3 micromol. min in controls) accompanied by an approximately 30% increase in net lactate uptake, suggesting preserved insulin action on both glucose uptake and glucose oxidation in the NIDDM heart. In nondiabetics, insulin consistently increased coronary blood flow, but this effect was absent in NIDDM. CONCLUSIONS: In contrast to their peripheral tissues and coronary vasculature, the myocardium of patients with NIDDM expresses a competent insulin-response system with respect to glucose metabolism. This suggests that insulin resistance is mediated at the level of individual organs and that different mechanisms are involved in muscle and vascular tissue.


Subject(s)
Diabetes Mellitus, Type 2/complications , Insulin/pharmacology , Myocardial Ischemia/complications , Angiography , Blood Glucose/drug effects , Coronary Circulation/drug effects , Diabetes Mellitus, Type 2/blood , Diabetes Mellitus, Type 2/metabolism , Fasting , Hemodynamics/drug effects , Humans , Lactic Acid/blood , Male , Middle Aged , Myocardial Ischemia/blood , Myocardial Ischemia/metabolism , Oxygen Consumption/drug effects
4.
Metabolism ; 49(10): 1365-9, 2000 Oct.
Article in English | MEDLINE | ID: mdl-11079831

ABSTRACT

Branched-chain amino acids (BCAAs) are oxidative energy substrates for the heart and may exert anabolic effects on myocardial protein. The factors regulating their myocardial uptake in patients with ischemic heart disease are therefore of interest. To examine whether myocardial BCAA utilization is influenced by the circulating insulin concentration, in 10 patients with chronic ischemic heart disease, we measured transmyocardial amino acid balance during fasting and again during a 90-minute euglycemic insulin infusion (plasma insulin, 218+/-25 microU x mL(-1)) with plasma BCAA concentrations held constant by coinfusion. In the fasting state, the myocardial fractional extraction of leucine (8%), isoleucine (9%), and valine (5%) from arterial plasma was slightly greater than that of glucose (3%), while net myocardial BCAA uptake (leucine, 409+/-207 nmol x min(-1); isoleucine, 220+/-144 nmol x min(-1); valine, 407+/-326 nmol x min(-1); and total BCAA uptake, 1.0+/-0.3 micromol x min(-1)) was about 13% that of glucose (8+/-2 micromol x min(-1)). During euglycemic hyperinsulinemia, myocardial glucose uptake increased 3-fold, but there was no change in the arterial-coronary sinus balance or net myocardial uptake of any BCAA under conditions where their plasma concentrations were held constant. Instead, the myocardial uptake of each BCAA correlated positively with its concentration in arterial plasma. These results demonstrate that in patients with cardiovascular disease, myocardial utilization of BCAAs is insensitive to the circulating insulin level and is regulated instead by their availability in arterial plasma. Hyperinsulinemia reduced the magnitude of both net glutamate uptake and alanine release, suggesting a possible salutary effect on myocardial oxidative efficiency.


Subject(s)
Amino Acids, Branched-Chain/metabolism , Coronary Disease/metabolism , Hyperinsulinism/metabolism , Myocardium/metabolism , Aged , Blood Glucose/analysis , Glucose/metabolism , Hemodynamics , Humans , Male , Middle Aged
5.
Am J Cardiol ; 85(2): 161-5, 2000 Jan 15.
Article in English | MEDLINE | ID: mdl-10955370

ABSTRACT

Considerable evidence suggests that coronary endothelium regulates myocardial blood flow and metabolism by elaborating vasoactive substances. The physiologic signals mediating this process are uncertain. To test the hypothesis that the process is influenced by physiologic variation in local insulin concentration, we examined the effect of direct intracoronary insulin infusion on myocardial blood flow and oxidative substrate metabolism in 10 patients with coronary heart disease. Ten men (aged 51 to 68 years) who were fasting received a 60-minute intracoronary infusion of insulin at a rate (10 mU/min) sufficient to raise coronary venous plasma insulin from 12+/-4 to 133+/-17 mU/ml without increasing the systemic insulin level. Local coronary hyperinsulinemia increased coronary sinus blood flow in every subject, from 50+/-4 to 61+/-6 ml/min (p<0.01). Insulin also increased myocardial uptake of glucose (from 6+/-1 to 17+/-6 mmol/min) and lactate (from 8+/-2 to 12+/-5 mmol/min), resulting in approximately 30% increase in total oxidative substrate uptake, but without increasing myocardial oxygen consumption (7.0+/-0.7 vs. 7.1+/-0.8 ml/min). Thus, physiologic elevation in the local plasma insulin concentration increases coronary blood flow in the absence of any increase in myocardial oxygen demand or consumption, suggesting a primary reduction in coronary tone, while simultaneously restraining the oxidation of imported substrates. These observations are consistent with insulin-mediated elaboration of vasoactive and/or paracrine factors within the coronary circulation.


Subject(s)
Coronary Circulation , Insulin/metabolism , Aged , Coronary Angiography , Hemodynamics , Humans , Male , Middle Aged , Myocardium/metabolism , Oxygen Consumption , Regional Blood Flow
6.
Am J Physiol Heart Circ Physiol ; 279(1): H375-81, 2000 Jul.
Article in English | MEDLINE | ID: mdl-10899078

ABSTRACT

Administration of supplemental glucose and/or insulin is postulated to improve the outcome from myocardial ischemia by increasing the heart's relative utilization of glucose as an energy substrate. To examine the degree to which circulating glucose and insulin levels actually influence myocardial substrate preference in vivo, we infused conscious, chronically catheterized rats with D-[1-(13)C]glucose and compared steady-state (13)C enrichment of plasma glucose with that of myocardial glycolytic ([3-(13)C]alanine) and oxidative ([4-(13)C]glutamate) intermediary metabolites. In fasting rats, [3-(13)C]alanine-to-[1-(13)C]glucose and [4-(13)C]glutamate-to-[3-(13)C]alanine ratios averaged 0.16 +/- 0.12 and 0.14 +/- 0.03, respectively, indicating that circulating glucose contributed 32% of myocardial glycolytic flux, whereas subsequent flux through pyruvate dehydrogenase contributed 14% of total tricarboxylic acid (TCA) cycle activity. Raising plasma glucose to 11 mmol/l, or insulin to 500 pmol/l, increased these contributions equivalently. At supraphysiological (>6,500 pmol/l) insulin levels, the plasma glucose contribution to glycolysis increased further, and addition of hyperglycemia made it the sole glycolytic substrate, yet [4-(13)C]glutamate-to-[3-(13)C]alanine ratios remained /=40% of myocardial TCA cycle flux.


Subject(s)
Glucose/metabolism , Insulin/blood , Myocardium/metabolism , Alanine/blood , Animals , Blood Glucose/metabolism , Carbon Isotopes , Citric Acid Cycle , Consciousness , Fasting , Glutamic Acid/blood , Glycolysis , Hyperglycemia/blood , Hyperinsulinism/blood , Male , Rats , Rats, Sprague-Dawley
8.
Am J Physiol Heart Circ Physiol ; 278(4): H1030-4, 2000 Apr.
Article in English | MEDLINE | ID: mdl-10749694

ABSTRACT

Menopausal status is a risk factor for coronary artery disease death, but the mechanism underlying this association is uncertain. To test whether estrogen ameliorates the effects of acute myocardial ischemia in ways likely to translate into a mortality difference, we compared the response to brief (6-min) and prolonged (45-min) coronary occlusion in vivo in five groups (each n = 16) of rats: ovariectomized females; ovariectomized females after 6 wk 17beta-estradiol replacement; male rats supplemented with estradiol for 6 wk; normal males; and normal females. Coronary occlusion produced a uniform ischemic risk area averaging 53 +/- 3% of left ventricular volume. After a brief occlusion, reperfusion ventricular tachycardia/fibrillation occurred with >85% frequency in all groups. During a prolonged occlusion, ischemic ventricular tachycardia occurred in 100% and sustained tachycardia requiring cardioversion in >75% of rats in all groups. Myocardial infarct size averaged 52 +/- 4% of the ischemic risk area and was similarly unaffected by gender or estrogen status. We conclude that neither short-term estrogen withdrawal, replacement, nor supplementation significantly affects the potentially lethal outcomes from acute coronary occlusion in this species.


Subject(s)
Estradiol/deficiency , Estradiol/pharmacology , Myocardial Ischemia/drug therapy , Animals , Coronary Disease/blood , Coronary Disease/drug therapy , Coronary Disease/pathology , Estradiol/blood , Female , Male , Menopause/physiology , Myocardial Infarction/blood , Myocardial Infarction/drug therapy , Myocardial Infarction/pathology , Myocardial Ischemia/blood , Myocardial Ischemia/pathology , Myocardial Reperfusion Injury/blood , Myocardial Reperfusion Injury/drug therapy , Myocardial Reperfusion Injury/pathology , Ovariectomy , Rats , Rats, Sprague-Dawley , Risk Assessment , Sex Factors , Tachycardia, Ventricular/blood , Ventricular Fibrillation/blood
9.
Circulation ; 101(8): 917-22, 2000 Feb 29.
Article in English | MEDLINE | ID: mdl-10694532

ABSTRACT

BACKGROUND: Rapid reperfusion of an occluded coronary artery salvages regional mechanical function, but this benefit may not be realized for hours or days because of postischemic stunning. Recovery from stunning is incompletely understood but may involve adaptive changes in heart glucose metabolism. METHODS AND RESULTS: To examine whether reversible coronary occlusion produces sustained changes in regional glucose metabolism in vivo, we performed a 20-minute left coronary artery occlusion followed by 24 hours of open-artery reperfusion in intact rats. Coronary occlusion produced stunning of the anterolateral left ventricle that resolved over 24 hours. When examined at 24 hours, reperfused regions were fully contractile and viable by vital staining and microscopy but demonstrated 25% reduction in blood flow and 50% increased uptake of circulating glucose, as estimated by in vivo [(13)N]NH(3) and [(18)F]fluorodeoxyglucose (FDG) tracer uptake. Reperfused regions had largely inactive glycogen synthase, low rates of glycogen synthesis, and persistent 50% glycogen depletion but increased flux of plasma [1-(13)C]glucose into myocardial [3-(13)C]alanine, indicating preferential shunting of imported glucose away from storage and into glycolysis. CONCLUSIONS: Sustained increases in regional glycolytic consumption of circulating glucose occur during reperfusion of a limited-duration coronary occlusion. This suggests a role for glycolytic ATP in the recovery from postischemic stunning in vivo. Furthermore, [(13)N]NH(3) /FDG regional mismatch may constitute a clinically accessible late metabolic signature of regional myocardial ischemia.


Subject(s)
Coronary Disease/complications , Glucose/metabolism , Myocardial Reperfusion Injury/metabolism , Myocardium/metabolism , Adenosine Triphosphate/physiology , Animals , Coronary Circulation , Deoxyglucose/metabolism , Energy Metabolism , Glycogen Synthase/metabolism , Male , Muscle Proteins/metabolism , Myocardium/enzymology , Rats , Rats, Sprague-Dawley , Time Factors
10.
Am J Physiol Heart Circ Physiol ; 278(3): H741-7, 2000 Mar.
Article in English | MEDLINE | ID: mdl-10710341

ABSTRACT

Physiological increases in circulating insulin level significantly increase myocardial glucose uptake in vivo. To what extent this represents a direct insulin action on the heart or results indirectly from reduction in circulating concentrations of free fatty acids (FFA) is uncertain. To examine this, we measured myocardial glucose, lactate, and FFA extraction in 10 fasting men (ages 49-76 yr) with stable coronary artery disease during sequential intracoronary (10 mU/min, coronary plasma insulin = 140 +/- 20 microU/ml) and intravenous (100 mU/min, systemic plasma insulin = 168 +/- 26 microU/ml) insulin infusion. Basally, hearts extracted 2 +/- 2% of arterial glucose and extracted 27 +/- 6% of FFA. Coronary insulin infusion increased glucose extraction to 5 +/- 3% (P < 0.01 vs. basal) without changing plasma FFA or heart FFA extraction. Conversion to intravenous infusion lowered plasma FFA by approximately 50% and heart FFA extraction by approximately 75%, increasing heart glucose extraction still further to 8 +/- 3% (P < 0. 01 vs. intracoronary). This suggests the increase in myocardial glucose extraction observed in response to an increment in systemic insulin concentration is mediated equally by a reduction in circulating FFA and by direct insulin action on the heart itself. Coronary insulin infusion increased myocardial lactate extraction as well (from 20 +/- 10% to 29 +/- 9%, P < 0.05), suggesting the local action may include stimulation of a metabolic step distal to glucose transport and glycolysis.


Subject(s)
Glucose/metabolism , Heart/drug effects , Insulin/administration & dosage , Myocardial Ischemia/metabolism , Myocardium/metabolism , Aged , Blood Glucose/metabolism , Coronary Vessels , Fatty Acids, Nonesterified/blood , Fatty Acids, Nonesterified/metabolism , Hemodynamics/drug effects , Humans , Infusions, Intravenous , Insulin/blood , Insulin/pharmacology , Lactic Acid/metabolism , Male , Middle Aged
11.
J Nucl Med ; 39(3): 379-83, 1998 Mar.
Article in English | MEDLINE | ID: mdl-9529278

ABSTRACT

UNLABELLED: This study was performed to evaluate the effect of insulin on myocardial kinetics of 18F-fluorodeoxyglucose (FDG) and glucose in patients with ischemic heart disease. METHODS: Twelve male patients (age range 54-79 yr; mean age 69 +/- 8 yr) were studied during the fasting awake state. Patients with diabetes and previous myocardial infarction of the left anterior descending vascular bed were excluded from the study. Patients were injected with a 185-MBq (5-mCi) bolus of FDG during arterial and coronary sinus catheterization. Thirty minutes after FDG injection, paired basal arterial and coronary sinus blood samples were taken for the measurement of FDG and glucose uptake. Thereafter, a primed (100 mU x m(-2) x min(-1) for 10 min) continuous (50 mU x m(-2) x min(-1) infusion of insulin was administered for 60 min using the euglycemic clamp technique, and blood samples were repeated. Blood samples also were taken periodically for the measurement of arterial free fatty acids and insulin. RESULTS: Euglycemic insulin infusion lowered arterial concentrations of free fatty acids, reducing myocardial extraction of free fatty acids by 85% and stimulated uptake of glucose and FDG. Myocardial glucose and FDG extraction fractions (%) increased from 1 +/- 1 and 2 +/- 2 at baseline to 8 +/- 2 and 10 +/- 3 during insulin infusion, respectively. The lumped constant value was estimated to be 1.44 +/- 0.14 (r = 0.87) for the fasted state, 0.99 +/- 0.07 (r = 0.74) during insulin infusion and 1.00 +/- 0.05 (r = 0.92) when both groups of data were pooled together. CONCLUSION: The data obtained in this study show that FDG uptake quantitatively traces glucose uptake during physiological hyperinsulinemia in patients with ischemic heart disease.


Subject(s)
Fluorine Radioisotopes , Fluorodeoxyglucose F18 , Heart/diagnostic imaging , Hyperinsulinism/physiopathology , Myocardial Ischemia/diagnostic imaging , Radiopharmaceuticals , Tomography, Emission-Computed , Aged , Cardiac Catheterization , Fatty Acids, Nonesterified/blood , Glucose Clamp Technique , Humans , Male , Middle Aged , Myocardial Ischemia/physiopathology , Myocardium/metabolism , Time Factors
12.
Am J Physiol ; 271(6 Pt 2): H2283-9, 1996 Dec.
Article in English | MEDLINE | ID: mdl-8997284

ABSTRACT

Ischemic preconditioning depletes the myocardium of glycogen, thus blunting lactic acidosis during subsequent episodes of ischemia. Preconditioning also protects against reperfusion arrhythmias and infarction. To test whether glycogen depletion is necessary for this ischemic tolerance, we preconditioned two groups of intact rats with a series of 3-min coronary artery occlusions. In one group, preconditioning lowered the glycogen concentration of the ischemic region by approximately 50% (24.9 +/- 2.5 to 12.5 +/- 1.8 mumol/g; P < 0.01). In the other, the heart was first loaded with glycogen via glucose-insulin infusion so that preconditioning merely reduced its glycogen concentration back to normal physiological levels. Compared with nonpreconditioned control rats, preconditioned rats with both normal and subnormal glycogen concentrations were protected from reperfusion arrhythmias after a 6-min coronary occlusion (incidence: control rats, 100%; normal glycogen rats, 11%; reduced glycogen rats, 11%). In contrast, only rats with subnormal glycogen concentration after preconditioning exhibited reduced lactate formation and infarct size after a 45-min coronary occlusion [infarct size (percentage of risk area): control rats, 53 +/- 10%; normal glycogen rats, 50 +/- 16%, P = not significant; subnormal glycogen rats, 18 +/- 10%, P < 0.01]. Thus, in the intact rat, myocardial glycogen depletion appears to be necessary for the infarct-limiting, but not for the antiarrhythmic, effects of ischemic preconditioning.


Subject(s)
Glycogen/deficiency , Ischemic Preconditioning, Myocardial , Animals , Blood Glucose/analysis , Coronary Disease/complications , Glycogen/metabolism , Hemodynamics , Lactic Acid/metabolism , Male , Myocardial Infarction/etiology , Myocardial Infarction/pathology , Myocardial Reperfusion Injury/complications , Myocardium/metabolism , Osmolar Concentration , Potassium/blood , Rats , Rats, Sprague-Dawley , Tachycardia, Ventricular/etiology
13.
Am J Physiol ; 271(2 Pt 2): R311-9, 1996 Aug.
Article in English | MEDLINE | ID: mdl-8770128

ABSTRACT

During hypoxia, the heart consumes glycogen to generate ATP. Tolerance of repetitive hypoxia logically requires prompt replenishment of glycogen, a process whose regulation is not fully understood. To examine this, we imposed a defined hypoxic stimulus on the rat heart while varying its workload. In intact rats, hypoxia reduced myocardial glycogen approximately 30% and increased both the fraction of glycogen synthase in its physiologically active (GS I) form (from 0.24 +/- 0.06 to 0.82 +/- 0.07; P < 0.005) and glycogen synthesis (from 0.087 +/- 0.011 to 0.375 +/- 0.046 mumol.g-1.min-1; P < 0.005). Reducing cardiac work (with propranolol or heterotopic transplantation) reduced glycogen breakdown, glycogen synthase activation, and glycogen synthesis in parallel, stepwise fashion in intact rats. Correspondingly, hypoxia increased GS I activity in the perfused heart in vitro, but only under conditions where glycogen was consumed. This suggests myocardial glycogen synthase is activated by systemic hypoxia and catalyzes rapid posthypoxic glycogen synthesis. Hypoxic glycogen synthase activation appears to be a proportionate, wholly intrinsic response to local glycogenolysis, operating to preserve myocardial glycogen stores independent of any extracardiac mediator of carbohydrate metabolism.


Subject(s)
Glycogen/metabolism , Homeostasis , Hypoxia/physiopathology , Myocardium/metabolism , Animals , Blood Pressure/drug effects , Gases/blood , Glucose-6-Phosphate/metabolism , Glycogen Synthase/metabolism , Heart Rate/drug effects , Heart Transplantation , Hypoxia/blood , Insulin/blood , Male , Myocardial Contraction , Osmolar Concentration , Oxygen/pharmacology , Propranolol/pharmacology , Rats , Rats, Sprague-Dawley
14.
J Clin Invest ; 98(1): 62-9, 1996 Jul 01.
Article in English | MEDLINE | ID: mdl-8690805

ABSTRACT

Myocardial regions perfused through a coronary stenosis may cease contracting, but remain viable. Clinical observations suggest that increased glucose utilization may be an adaptive mechanism in such "hibernating" regions. In this study, we used a combination of 13C-NMR spectroscopy, GC-MS analysis, and tissue biochemical measurements to track glucose through intracellular metabolism in intact dogs infused with [1-13C]glucose during a 3-4-h period of acute ischemic hibernation. During low-flow ischemia [3-13C]alanine enrichment was higher, relative to plasma [1-13C]glucose enrichment, in ischemic than in nonischemic regions of the heart, suggesting a greater contribution of exogenous glucose to glycolytic flux in the ischemic region (approximately 72 vs. approximately 28%, P < 0.01). Both the fraction of glycogen synthase present in the physiologically active glucose-6-phosphate-independent form (46 +/- 10 vs. 9 +/- 6%, P < 0.01) and the rate of incorporation of circulating glucose into glycogen (94 +/- 25 vs. 20 +/- 15 nmol/gram/min, P < 0.01) were also greater in ischemic regions. Measurement of steady state [4-13C)glutamate/[3-13C]alanine enrichment ratios demonstrated that glucose-derived pyruvate supported 26-36% of total tricarboxylic acid cycle flux in all regions, however, indicating no preference for glucose over fat as an oxidative substrate in the ischemic myocardium. Thus during sustained regional low-flow ischemia in vivo, the ischemic myocardium increases its utilization of exogenous glucose as a substrate. Upregulation is restricted to cytosolic utilization pathways, however (glycolysis and glycogen synthesis), and fat continues to be the major source of mitochondrial oxidative substrate.


Subject(s)
Coronary Disease/metabolism , Coronary Vessels/physiology , Glucose/metabolism , Magnetic Resonance Spectroscopy/methods , Alanine/analysis , Animals , Disease Models, Animal , Dogs , Endocardium/chemistry , Fatty Acids, Nonesterified/metabolism , Female , Glutamic Acid/analysis , Glycogen/metabolism , Glycolysis , Male , Oxidation-Reduction , Pericardium/chemistry , Regional Blood Flow
15.
Am J Physiol ; 270(1 Pt 1): E60-6, 1996 Jan.
Article in English | MEDLINE | ID: mdl-8772474

ABSTRACT

Infusion of insulin-like growth factor I (IGF-I) lowers plasma amino acid and insulin concentrations, which may limit the capacity of IGF-I to promote muscle protein synthesis in vivo. We measured heart and skeletal muscle incorporation of continuously infused L-[ring-2,6-3H]phenylalanine in awake postabsorptive rats receiving 4-h intravenous infusions of saline (n = 11), IGF-I (1 microgram.kg-1.min-1) with (n = 10) or without (n = 11) amino acid replacement, or IGF-I with insulin replacement (n = 8). There were no significant increases in muscle protein synthesis during the infusion of IGF-I alone, which was associated with decreases in both plasma insulin (52 +/- 5%, P < 0.001) and amino acids (25 +/- 5%, P < 0.05). When IGF-I was given together with amino acids, protein synthesis was significantly increased in gastrocnemius (4.7 +/- 0.4 vs. 2.5 +/- 0.3%/day, P < 0.001), oblique (4.5 +/- 0.4 vs. 2.8 +/- 0.4%/day, P < 0.05), and soleus (8.8 +/- 0.7 vs. 6.4 +/- 0.3%/day, P < 0.01) and tended to be higher than saline control values in heart (10.9 +/- 0.9 vs. 8.8 +/- 0.7%/day, P = 0.08). Amino acid replacement prevented plasma concentrations from falling and also blunted the decline in plasma insulin (22 +/- 5%, P < 0.01 vs. IGF-I alone). When IGF-I and insulin replacement were given, protein synthesis was increased in heart (13.0 +/- 0.6%/day), gastrocnemius (4.7 +/- 0.4%/day), and oblique (4.5 +/- 0.4%/day) (P < 0.001 for each, compared with saline). We conclude that the action of IGF-I to acutely stimulate muscle protein synthesis in the awake rat is limited by the fall in circulating insulin and/or amino acid concentrations that accompanies IGF-I infusion in vivo and is prevented by co-infusion of insulin or amino acids.


Subject(s)
Amino Acids/physiology , Insulin-Like Growth Factor I/pharmacology , Insulin/physiology , Muscle Proteins/biosynthesis , Animals , Infusions, Intravenous , Male , Muscle, Skeletal/metabolism , Myocardium/metabolism , Phenylalanine/metabolism , Rats , Rats, Sprague-Dawley
16.
Circulation ; 92(8): 2151-6, 1995 Oct 15.
Article in English | MEDLINE | ID: mdl-7554195

ABSTRACT

BACKGROUND: Insulin resistance, hyperinsulinemia, and myocardial hypertrophy frequently coexist in patients. Whether hyperinsulinemia directly affects myocardial protein metabolism in humans has not been examined, however. To test the hypothesis that hyperinsulinemia is anabolic for human heart protein, we examined the effects of insulin infusion on myocardial protein synthesis, degradation, and net balance in patients with ischemic heart disease. METHODS AND RESULTS: Eleven men (aged 57 +/- 3 years) with coronary artery disease who had fasted for 12 to 16 hours received a constant infusion of insulin (50 mU.m-2.min-1) while plasma concentrations of glucose and amino acids were kept constant. Rates of myocardial protein synthesis, degradation, and net balance were estimated from steady state extraction and isotopic dilution of L-[ring-2,6-3H]phenylalanine across the heart basally and 90 minutes into infusion. Subjects had elevated fasting plasma insulin concentrations (173 +/- 21 pmol/L) and used little exogenous glucose during insulin infusion, suggesting resistance to the effects of insulin on whole-body carbohydrate metabolism. Basally, myocardial protein degradation, as estimated by phenylalanine release (133 +/- 28 nmol/min), exceeded protein synthesis, estimated by phenylalanine uptake (31 +/- 15 nmol/min), resulting in net negative phenylalanine balance (-102 +/- 17 nmol/min). Insulin infusion reduced myocardial protein degradation by 80% but did not affect protein synthesis, returning net phenylalanine balance to neutral. CONCLUSIONS: Acute hyperinsulinemia markedly suppresses myocardial protein degradation in patients with cardiovascular disease who are resistant to its effects on whole-body glucose metabolism. This antiproteolytic action represents a potential mechanism by which hyperinsulinemia could contribute to the development of myocardial hypertrophy in patients with cardiovascular disease.


Subject(s)
Coronary Disease/metabolism , Hyperinsulinism/metabolism , Insulin Resistance , Insulin/blood , Muscle Proteins/metabolism , Myocardium/metabolism , Phenylalanine/metabolism , Amino Acids/metabolism , Blood Glucose/metabolism , Fatty Acids, Nonesterified/metabolism , Glucose/metabolism , Humans , Insulin/administration & dosage , Male , Middle Aged
17.
Am J Physiol ; 268(1 Pt 1): E48-54, 1995 Jan.
Article in English | MEDLINE | ID: mdl-7840181

ABSTRACT

To determine whether the contractile work history of cardiac muscle influences its responsiveness to insulin, we examined the effect of insulin infusion on glycogen metabolism in the rat heart 1 wk after transplantation into a nonworking heterotopic infrarenal position. Nonworking heterografts had higher basal glycogen concentrations than did in situ working hearts of the same animals (29.9 +/- 2.7 vs. 23.3 +/- 0.8 mumol/g; P < 0.05), and a smaller fraction of their glycogen synthase enzyme activity was in the physiologically active glycogen synthase I form (8 +/- 2 vs. 22 +/- 3%; P < 0.02). During a 25-min infusion of insulin (1 U/min) and glucose (30 mg.kg-1.min-1), the fractional glycogen synthase I activity of heterografts remained lower than that of in situ hearts (29 +/- 5 vs. 56 +/- 7%; P < 0.02) and heterografts synthesized glycogen more slowly (0.126 +/- 0.07 vs. 0.352 +/- 0.06 mumol.g-1.min-1; P < 0.02). These effects could be duplicated by a 24-h fast, which similarly increased myocardial glycogen concentration (to 32.9 +/- 5.6 mumol/g). These observations suggest that the performance of repetitive contractile work is necessary to maintain the myocardium maximally responsive to insulin. Mechanical unloading increases myocardial glycogen concentration, thereby reducing the magnitude of insulin's stimulation of glycogen synthase and consequently the rate of incorporation of circulating glucose into glycogen.


Subject(s)
Glycogen/metabolism , Heart Transplantation , Myocardium/metabolism , Transplantation, Heterotopic , Animals , Fasting , Glucose-6-Phosphate , Glucosephosphates/metabolism , Glycogen Synthase/metabolism , Heart/anatomy & histology , Insulin/pharmacology , Male , Muscle Proteins/metabolism , Organ Size , Phosphorylases/metabolism , Rats , Rats, Inbred Lew
18.
Am J Physiol ; 268(1 Pt 2): H364-70, 1995 Jan.
Article in English | MEDLINE | ID: mdl-7840285

ABSTRACT

Glycogen is consumed during ischemic preconditioning and synthesized during the subsequent period of ischemic tolerance. To better understand this sequence, we examined the effect of brief coronary artery occlusions on regional myocardial glycogen metabolism in intact, anesthetized rats. Sequential 2-min periods of left coronary artery occlusion reduced the glycogen concentration of the anterior left ventricle approximately 30% relative to the posterior region. During subsequent reperfusion, the activity of the physiologically active glycogen synthase I form of glycogen synthase increased threefold in the anterior region (0.58 +/- 0.11 vs. 0.18 +/- 0.08 mumol.g-1.min-1, P < 0.01), stimulating a similar regional increase in glycogen synthesis rate (0.24 +/- 0.04 vs. 0.08 +/- 0.03 mumol.g-1.min-1, P < 0.01). These events were preceded by a rise in regional glucose 6-phosphate concentration, which increased the activity of a myocardial glycogen synthase phosphatase. In diabetic rats glycogen synthase phosphatase activity was significantly lower, and postischemic glycogen synthase activation was significantly impaired. These data suggest the operation of a feedback loop in which transient ischemia leads to a glucose 6-phosphate-mediated increase in the activity of a phosphoprotein phosphatase active toward glycogen synthase. This suggests phospho-protein phosphatase activation may be a feature of the preconditioned myocardium.


Subject(s)
Diabetes Mellitus, Experimental/metabolism , Glycogen Synthase/biosynthesis , Glycogen/biosynthesis , Myocardial Ischemia/metabolism , Myocardial Reperfusion , Myocardium/metabolism , Animals , Coronary Vessels/physiology , Enzyme Induction , Glucose/metabolism , Glucose-6-Phosphate , Glucosephosphates/metabolism , Glycogen-Synthase-D Phosphatase/metabolism , Kinetics , Male , Rats , Rats, Sprague-Dawley , Reference Values , Regression Analysis , Time Factors
19.
Am J Physiol ; 267(2 Pt 1): E337-42, 1994 Aug.
Article in English | MEDLINE | ID: mdl-8074214

ABSTRACT

In vivo measurement of muscle protein synthesis and its hormonal regulation is limited by the difficulty of measuring aminoacyl-tRNA specific activity (SA). We assessed the kinetics of heart and skeletal muscle phenylalanyl-tRNA labeling during continuous infusion of L-[ring-2,6-3H]phenylalanine (Phe) to fasted anesthetized rats. We measured Phe SA in arterial and femoral venous plasma, the tissue acid-soluble pool and muscle protein hydrolysates after 5 min (n = 7), 30 min (n = 6), and 90 min (n = 7). We also assessed insulin's effect on labeling of the tRNA pool and muscle protein synthesis during a hyperinsulinemic clamp (2 mU.kg-1.min-1; n = 7). Labeling of tRNA in heart reached 59 +/- 5, 67 +/- 3, and 83 +/- 3% of arterial SA at 5, 30, and 90 min of saline infusion, respectively, but only 10 +/- 5, 34 +/- 2, and 48 +/- 2% in skeletal muscle at those times (P < 0.01 vs. heart). The tRNA SA was intermediate between SA in the acid-soluble pool and arterial plasma. Femoral venous SA was 32 +/- 2% lower (P < 0.001) than arterial SA. Skeletal muscle tRNA SA was also 29 +/- 3% lower (P < 0.001) than femoral venous SA. Insulin did not alter tRNA labeling and neither heart (9.8 +/- 1.1%/day for saline vs. 8.4 +/- 1.0%/day for insulin) nor skeletal muscle (6.7 +/- 1.5%/day vs. 4.2 +/- 0.4%/day) protein synthesis. Thus labeling of phenylalanyl-tRNA occurs more rapidly in heart than in skeletal muscle and is unaffected by insulin.(ABSTRACT TRUNCATED AT 250 WORDS)


Subject(s)
Insulin/pharmacology , Muscle Proteins/biosynthesis , Muscles/metabolism , Myocardium/metabolism , Phenylalanine/genetics , RNA, Transfer/metabolism , Animals , Male , Phenylalanine/blood , Phenylalanine/pharmacology , Rats , Rats, Sprague-Dawley
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